Participant Interest Form: Resource Matching Program

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PPCC is excited to announce the launch of the Resource Matching Program, a new pilot initiative supported by the Edith L. Trees Charitable Trust. This program aims to connect families of children with complex medical conditions (CMC) and intellectual and developmental disabilities (IDD) to reliable resources, helping ease the challenges of navigating these needs. The service will be provided at no cost to families and will be customized to match families with resources based on their specific needs, including those not directly offered by PPCC.

If you are a parent or legal caregiver of a child with CMC and IDD and are interested in participating in the pilot program, please complete the interest form. The pilot will launch in Fall/Winter 2025 and run for approximately six months. As a participant, PPCC will be in contact with you regularly to listen to your concerns, assess areas where additional support may be needed, and suggest relevant resources for your family.

Participants must agree to the following criteria:

Your child resides in Pennsylvania or receive treatment/care at a Pennsylvania facility/hospital.

Completion of a basic intake form to provide PPCC with information about your family (all personal and health data will be kept confidential).

Participation in regular phone or Zoom meetings with PPCC upon program launch (approximately once a week).

Use of a new web-based application to track and organize your child’s medical records, information, and resources.

Completion of pre- and post-program surveys.

Additional criteria may be introduced as the program develops.

Thank you for your interest! A member of our team will be in touch with you as soon as possible.

Last name *

First name *

Email address *

Phone number *

Street Address

City *

State *

Zip Code

Relationship to child with CMC & IDD: *

Mother

Father

Legal guardian

Other:

Please briefly tell us a little bit about your child with CMC/IDD including their age as well as any other detail you wish to share about their medical conditions or about your family. *

Please share where your child receives the majority of their medical care.

Please share what interests you in participating in this pilot program. *

Additional questions or comments:

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