Name*

Please provide your first and last name.

Email*

Phone*

Preferred way to be contacted*

Phone
E-mail
Text

Phone Carrier*

Please provide the name of your cell phone carrier so that we will be able to text you. Ex: Verizon, AT&T, or Sprint

Please list the ages of your children

Are you or your child a Trillium member?*

Yes
No

If you are not a Trillium member but are still interested in doing a parenting education program, you have a couple options: First, you can purchase one-year access to Triple P Online from Triple P International for $79.99. Second, you may want to participate in an in-person parenting group or program located at Parenting Now!

Your Options*

I would like to receive a free Triple P Online registration code immediately.

Please select the option above and an e-mail with more information will be sent directly to your inbox after you submit this form.

Your Options*

I am interested in purchasing the Triple P Online Program for $79.99.
I am interested in learning more about in-person parent groups and programs at Parenting Now!

Please select the appropriate choice, and an e-mail with more information will be sent directly to your inbox after you submit this form.

How did you find out about the Triple P program?*

Doctor/Pediatrician
Counselor/Therapist
A friend or relative
An agency (ex: Parenting Now! or DHS)
Facebook
Google/the Internet
Magazine or newspaper
Poster

Name of healthcare provider

Please provide us with the name of your doctor or counselor in order for us to better evaluate our referral system. Your provider will only be informed that you signed up for the program. ***Please note: this information is completely voluntary.***

Triple P Online: Positive Parenting Program

Triple P is an online course designed for parents of children ages 2-12.

You can access the program anytime on any device for 1 year after you activate your code!

Information is delivered in video format with activities that customize the program to your family.

**Triple P doesn’t tell you how to parent, it gives you strategies that you can adapt to your unique situation.**

If you or your child are on Oregon Health Plan (OHP) through Trillium Community Health Plan, you can get Triple P Online for free by filling out the form below. A staff person from Parenting Now! will send you an access code within 24 hours and you’ll be able to start using the program right away!

Triple P Sign-up Form

Preschool Storytime

Baby & Toddler Storytime

Preschool Storytime