Would you be interested in talking to a trained parent educator about any parenting questions or concerns?
*
Yes
No
If yes, what topics and types of things would you be interested in talking about during your consultation?
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Ages and Stages
Behavior Concerns
Education and school readiness
Engaging and connecting with your child
Becoming a first-time dad
Supporting your spouse/partner
All of the above
None/not interested
Other:
If yes, could I contact you about this as more information is available? (please provide name and contact information)
First Name
Last Name
Email