CY'22: It Takes a Village Registration Form

This Early Intervention Program presentation will provide an overview of the Early Intervention process (from referral to transition) to parents. You will receive a link via email to join the presentation after you have registered.

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* 1. Name

Firstname:

Lastname:

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* 2. Email address

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* 3. Zip code

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* 4. Please select the date and time you would participate.

CLOSED FOR 2022. SEE NEW DATES FOR 2023 COPY LINK BELOW AND OPEN IN YOUR BROWSER
https://nycdohmh.surveymonkey.com/r/CY23ParPres

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* 5. How did you hear about the presentation?

Text 2 Families

Early Intervention Outreach

Provider (hospital, WIC, faith-based, library, etc..)

Facebook

Partnership/Network (Jamaica Community Partnership, East Flatbush Community, etc...)

Other

Friend

Family