• Flock-Premier Pediatrics Parent Skills Training Welcome Survey

    We’re thrilled you’d like to participate in Flock’s Parent Skills Training. Please complete this questionnaire to complete your sign up. Your responses will help us know how to best support you. It should take you 10 minutes to complete. We will ask you to complete a similar survey at the conclusion of the training. We are gathering this information to evaluate the impact of the training using standardized scales. Please know your responses will be totally private and only used to evaluate the efficacy of the training.
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  • Do you consent to receiving text messages from Flock? These would be reminders about the sessions and skills learned. We promise not to spam you!*
  • What is your child's gender identity?*
  • Will your partner or co-parent be joining? *
  • Format: (000) 000-0000.

  • Please confirm your family is a match for this training which draws on material developed for and proven to meet the specific needs of families raising children:

    • Under 10 with ADHD
    • Who do not have other additional neurodivergence that you know of
    • Who are not experiencing persistent high levels of physical aggressive behaviors from their child
    • Who are not engaging in self harm

  • Please review our community norms.

    • Watch the short training content each week.
    • Commit to attending every live Zoom, with video on as much as possible.
    • The 6 sessions will be on Tuesdays at 12pm ET from September 22nd to October 27th.
    • Practice the skill(s) learned each week in between each session.
    • Complete a pre and post training survey.
    • Bring a spirit of learning, participation, and mutual support.
    • Collaborate with other parents to problem solve pressing parenting challenges.

  • Understanding Your Parent Experience

    As a reminder, we're gathering data before (and after) this training to understand impact and efficacy.
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  • Understanding Your Parent Experience

    While you may not find a response that exactly states your feelings, please select the response that comes closest to describing how you feel. Your first reaction to each question should be your answer.
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  • I feel that I am: (Choose a response from the choices below.)*
  • I have found that getting my child to do something or stop doing something is: (Choose a response from the choices below.)*
  • Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. (Choose a response from the choices below.)*

  • Understanding Your Parent Experience

    Please rate how much you agree with the statements below. 1 = strongly disagree; 6 = strongly agree
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  • Understanding Your Parent Experience

    Please rate how big of a problem your child's ADHD is in relation to the questions below. 1 = no problem; 5 = extreme problem
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  • Demographic Information

    To help us report to our funders, we're collecting a few demographic questions. This information helps Flock demonstrate the impact of our work and the communities we serve.
  • What is your approximate annual household income? *
  • How would you describe your race/ethnicity? (Select all that apply)*

  • TRAINING PARTICIPATION WAIVER

    This waiver gives you information about who is involved in the training, informs you that the training does not create a clinical relationship, and explains that Flock will use data only for improvement and internal work.

  •  Pulley Sled LLC, functioning as Flock (“we” or “us” or “Flock”) offers this training as a service for the benefit of our users (“you” or the “users”). 

    I acknowledge that I have voluntarily chosen to participate in the Flock parent training program in collaboration with Dr. Anil Chacko’s Families and Children Experiencing Success lab (the “Training”) as organized and facilitated by Flock (“we” or “us” or “Flock”). By signing below, I understand and agree to the following terms (the “Terms”). I further acknowledge that any prior terms of use, privacy policies, or participant agreements issued by Flock remain in full force and continue to apply to my participation.

    If you do not agree to be bound by these Terms, you may not access the Training in any manner.

    Medical Advice Disclaimer

     THE TRAINING WILL NOT PROVIDE MEDICAL ADVICE OR CONSISTUTE A CLINICAL RELATIONSHIP. You understand that the Training is educational in nature and provided for general informational purposes only. It is not medical, psychological, diagnostic, or legal advice, and does not substitute for individualized assessment, treatment, or guidance from qualified professionals. You will consult a licensed professional for any diagnosis, treatment plan, or legal issues concerning a child in your care.

    Confidentiality and Privacy

    You agree to strictly respect the privacy and confidentiality of other participants and any information discussed during the Training. You will not record, share, reproduce, or disclose any personally identifying information about other participants without their express written consent. Participants should use their best judgment when sharing information and should, at their discretion, refrain from disclosing any sensitive personal or private information, including personal information about children. By participating in the Training, you acknowledge and accept the risks associated with sharing such information in an online community.

    You understand that Flock may collect data and written records of Training sessions for quality, archival, and educational purposes. By participating, you consent to such data collection and to Flock’s use of related content for learning and organizational purposes. You further acknowledge and agree that your information may be used in furtherance of Flock’s mission and shared with our partners for limited purposes such as research. Flock will only share anonymized data.  

    Intellectual Property 

    Training materials, videos, slides, handouts, recordings, transcripts, and any related content, including derivative works created by or for Flock (collectively, the “Training Materials”) are the exclusive intellectual property of Flock or its licensors, including third-party presenters. No title or ownership rights are transferred to you. Subject to your compliance with these terms, Flock grants you a limited, revocable, non-exclusive, non-transferable, non-sublicensable license to access and use the Training Materials solely for your personal, non-commercial use to participate in the Training. You will not, and will not permit any third party to, reproduce, distribute, publish, publicly display, sell, license, modify, adapt, or create derivative works of the Training Materials without prior written permission from Flock or the applicable third party.  You will not  record audio or video of any live session, or otherwise capture the Training Materials. If you provide feedback, comments, or suggestions regarding the Training Materials or Flock’s offerings, you grant Flock a perpetual, irrevocable, worldwide, royalty-free license to use such feedback without restriction or attribution. Portions of the Training Materials may include or link to content owned by third parties. Such content is used with permission, and your use is subject to the rights and restrictions of those third parties. Where third-party terms apply, you agree to comply with them. Except for the limited license expressly granted, all rights in and to the Training Materials are reserved by Flock and its licensors.

    Disclaimer of Warranties and Assumption of Risk

    Flock makes no representations or warranties regarding the completeness, accuracy, or effectiveness of the information presented. All materials, including without limitation Training Materials, are provided “as is” and without warranty of any kind.

    PARTICIPATION IN THE TRAINING IS AT YOUR EXCLUSIVE RISK, AND ANY SUBSEQUENT RISK OF INJURY RESTS EXCLUSIVELY WITH YOU. You understand that applying any content provided or discussed in the Training, including without limitation Training Materials, may involve risks. You knowingly and voluntarily assume all risks, whether foreseeable or unforeseeable, arising from participation in the Training and from implementing any information obtained from the Training.

    LIMITATION OF LIABILITY

    TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, UNDER NO CIRCUMSTANCES AND UNDER NO LEGAL THEORY, SHALL FLOCK OR LUMINARY IMPACT FUND (in its capacity as the fiscal sponsor to Pulley Sled LLC functioning as Flock) OR RESEARCHERS BE LIABLE TO YOU OR TO ANY OTHER PERSON FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE OR CONSEQUENTIAL DAMAGES OF ANY KIND ARISING OUT OF OR IN ANY WAY CONNECTED WITH YOUR PARTICIPATION IN THE TRAINING, THE USE OF INFORMATION OBTAINED FROM THE TRAINING, TRAINING MATERIALS, OR FLOCK’S PROVISION OR FACILITATION OF THE TRAINING.

    Indemnification

    You agree to indemnify, defend and hold Flock, Luminary Impact Fund, and researchers harmless from and against any and all claims, liabilities, losses, damages, costs and expenses (including attorneys’ fees) of any kind or nature arising out of your actions, omissions, participation in the Training or use of the Training materials; and in any case whether or not your acts or omissions are intentional, reckless or negligent.

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