LANTERN Initiative Membership Interest Form

Caring for a child with medical complexity or other serious, life-limiting illnesses is overwhelming. This can be even more challenging when the child is also living with intellectual or developmental disabilities.

The LANTERN Initiative is designed to support parents and caregivers by educating families and connecting them to trusted resources and while building a community of support. No one should navigate this alone. 

What is required to participate?

  • Must be a parent or primary caregiver of a child with a serious, life-limiting illness, complex medical condition (CMC) and/or other disabilities
  • Resident of Pennsylvania (or have a child receiving long term care in Pennsylvania)
  • Willingness to use of a secure web-based app (Firefly)
  • Review and digital signature of the LANTERN Initiative Membership Agreement (this will be emailed to you shortly after submitting this form)
What is included in the program?
  • Consistent member support from the PPCC LANTERN team to help identifying resources
  • Access to Firefly (supported by Villages by Thanacare), a secure tool to privately store important information about your child’s care, wishes, and preferences in a digital care plan. It also enables communication with PPCC’s LANTERN team and provides quick access to curated digital resource library, a moderated community forum, and more.
  • Access to curated resources on the Firefly Digital Library and the PPCC Resource Map
Other optional selections as a member include:
  • Direct referrals to peer support and other community-based services
  • A tangible copy of PPCC's Care Plan Book
  • Opportunity to join PPCC's Parent Advisory Council, a group of parents from across Pennsylvania who work with PPCC in the areas of resource creation, fundraising, outreach and advocacy.
  • Registration and access to PPCC Educational Series including PPCC Webinars , Firefly Chats, &  Deeper Dives (3) 
  • A free Sibling Support kit for families with brothers and/or sisters
There is no cost to become a member. 

If you have any additional questions, please contact Krista@ppcc-pa.org.
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Email *
Last name *
First name *
Phone number *
Are you open to text message communications?
(Mark "no" if the number you provided is a land line)
PPCC staff will only send texts if needed. 
You will not recieve marketing texts from PPCC.
 *
Mailing Address *
City *
State *
Zip Code *
Email address *
Relationship to child with CMC, life-limiting illnesses and/or other disabilities: *
Are you caring for more than one child with CMC or other life-limiting illnesses? *
If comfortable doing so, please elaborate on your child's medical conditions or disabilities.
All shared information is kept strictly confidential.
(if you have multiple children, please answer for each)
What medical facility/hospital cares for your child? 
You may list multiple
(if you have multiple children, please answer for each)
How did you hear about the LANTERN Initiative? *
In what areas could you use more support in identifying resources? 
(you may select multiple)
 *
Required
Please let us know if you have any additional questions or comments here and we will be in touch as soon as possible. 
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