Peer Connect Form Kindred Connect First Name(Required) Your Last Name(Required) Email(Required) Phone(Required)Post Code(Required) Relationship to child(Required) Mother Father Caregiver Family member Other What is your child/children's primary diagnosis? How did you hear about Kindred Connect?(Required) Kindred Website Kindred Facebook Kindred Instagram Other Social Media page Therapist Hospital Friend or family member Word of mouth Other Age of child(Required) Are there any topics that you would like to focus on in the Kindred Connect session? Do you prefer(Required) Typed chat Video call Phone call Do you have any accessibility requirements? (For example, an interpreter or hearing support) Consent I consent to Kindred collecting and storing my information for the purposes of providing targeted support services.