Connect with a Parent Match in New York State

If you live in New York State and would like to be matched with a Support Parent, please complete and submit this form. We will act on your request as quickly as possible, however, please keep in mind that our Coordinators are parents themselves and most work on a part-time basis. You may follow-up on this request by phoning your Regional Coordinator if you feel it is necessary.

Request a Parent Match

Name(Required)
Please spell out the borough or county in New York State in which you reside.
My relationship with a person with a special need is as a(Required)
Address

Required Data Collection

Our funders require that we report the following information in percentages of people served, no one is individually identified.
Are you Hispanic or Latino?(Required)
Your Primary Language(Required)

About the person with a special need (PWSN)

In this section, enter the requested information regarding the person with a special need for whom you are a Parent/Family Caregiver.
Permission to Release *
In order to complete this request for a parent match, we need your permission to give the selected Support Parent basic information about you so that they may contact you. Do you grant Parent to Parent of NYS permission to release your name, phone number and/or Email address to a Support Parent in order to complete this request for a Parent Match?
This field is for validation purposes and should be left unchanged.
{ "@context": "https://schema.org", "@type": "ProfessionalService", "name": "Parent to Parent of NYS", "image": "", "@id": "https://www.parenttoparentnys.org", "url": "https://www.parenttoparentnys.org", "telephone": "518-381-4350", "address": { "@type": "PostalAddress", "streetAddress": "500 Balltown Rd.", "addressLocality": "Schenectady", "addressRegion": "NY", "postalCode": "12304", "addressCountry": "US" }, "geo": { "@type": "GeoCoordinates", "latitude": 42.7786951, "longitude": -73.89128950000001 } , "sameAs": [ "https://www.facebook.com/ParentToParentNYS", "https://twitter.com/ptopofnys", "https://www.instagram.com/parenttoparentnys/" ] }