If you need any help with this form, you can call us on 0808 800 3333.
You must answer all the questions marked with an asterisk (*).
Parents Connect may not be suitable for you. If you’d like to discuss this with us, please complete this application and we'll contact you.
Parents Connect is for parents of disabled children. Your child does not need to have a medical diagnosis. If you’d like to discuss this with us, please complete this application and we'll contact you.
To use this service we’d like to contact you by phone and by email before arranging for you to join a group. Please tell us if you have any access requirements.
We will not use your details for marketing or fundraising.
Calls will be between 9am and 5pm on the days selected.