CPAC Connecticut Parent Advocacy Center
Connecticut's Resource for Children with Disabilities Connecticut Parent Advocacy Center Connecticut Parent Advocacy Center
Connecticut's Resource for Children with Disabilities;
Empowering and Educating Families

Support Record Form

Online Support Record Form

Please complete the form shown below. Required fields are indicated with an asterisk (*). Click Submit when you are finished to submit the form to CPAC.

* Parent Mentor



Parent Mentee Information
* Last Name


First Initial


* Child's Name


* Date Assigned (DD/MM/YYYY)


* Contact Date (DD/MM/YYYY)


* Time Spent


* Description


* Comments and Concerns


* Suggestions and Referrals


Other CPAC Programs

Match Request

Match
Request

Interested in receiving support from a Parent Mentor?

Support Another Parent

Support Another Parent

Interested in helping support another parent of a child with a developmental delay/disability?

Meet our parent mentors

Meet our parent mentors

Meet our parent mentors and connect with them!

Parent Mentor Portal

Parent Mentor Portal

Online training modules, job description, Q&A, and more...

Training
Resources

Training for Families and Professionals

Your Child's Development

Child
Development

Sparkler App and other resources

Communicating Your Child's Needs

Communicating Needs

Techniques for communicating your child's needs to professionals

DEC Recommended Practices

DEC
Practices

Division of Early Childhood (DEC) Recommended Practices

Learning Series

Learning Series

Learning Series with Early Childhood Professionals

Family's Stories

Family Stories

Watch videos to learn more about some Connecticut family stories

Developmental Games

Games

Developmental Games for preschoolers and young children

aRPy

aRPy

Meet CPAC's aRPy Ambassdors