Basehor-Linwood Parents As Teachers Enrollment
If you are interested in enrolling and receiving monthly home visits with Parents as Teachers, please fill out the form below.  Home visits are typically once a month and lasting about 60 minutes in length.  We complete developmental screenings, discuss child development and topics related to parenting.  Visits are offered to all families in the Basehor-Linwood school district with children between the ages of birth-5* years old. A Parent Educator will contact you once we receive this form.  Thank you for your interest in PAT!

*we will prioritize birth-3 year olds, but serve 3-5 if there is a younger sibling or no/limited access to preschool.  
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Time of day available to do monthly home visits? *
Parent Name(s) *
Are you a first time parent? This isn't a requirement of the program but does help up prioritize our enrollments.  *
Home Address (Must be in the Basehor-Linwood school district boundaries) *
Phone Number *
Email Address *
Full name of Child(ren) (Including middle name) *
Date of Birth of Child(ren) *
Do you have any concerns about your child's development? *
How did you hear about Parents as Teachers?
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Do you have a child currently attending the Basehor-Linwood Early Learning Center?
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Any other information you'd like us to know about your family prior to enrollment?
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