Become a Pediatric Therapy Professional Family Connection Peer

Fieldset

  • Please complete and submit the required information below. Once your form is submitted, a Regional Coordinator will contact you to personally explain our program and services. This call helps to ensure that you understand our program and your responsibilities as a Pediatric Therapy Professional Family Connection Peer.. Please be aware that you will not be listed as a Pediatric Therapy Professional Family Connection Peer until a Parent to Parent of PA Regional Coordinator has spoken to you directly. All Information is required.
 

Verification