Connect to a Parent Volunteer

Welcome. You are not alone. We are here for you. This form will connect you with a National Prenatal First Call parent who also received a suspected or confirmed prenatal diagnosis. The phone conversation will be confidential. If you have any questions about completing the form, you may email nationalfirstcall@mdsc.org.

* = required

About You

First Name

Last Name

Your Initials*

I am:

An expectant Mom
The spouse or significant other of an expectant Mom

About Your Pregnancy

Have you (or your spouse/significant other) received prenatal screening test results (involving bloodwork and ultrasound) that indicate a higher chance that your baby has Down syndrome?*

Yes
No

Have you (or your spouse/significant other) received a diagnosis of Down syndrome through a CVS or amniocentesis?*

Yes
No

Due Date*

Approximate number of weeks gestation/pregnancy today*

Optional Additional Information

Please share the following information to help us make the most meaningful connection when possible:

Ethnicity of Parent(s):

Primary Language:

We may be able to connect you with a bilingual First Call parent.

Any health/medical information about the pregnancy and/or your background or family structure that could be helpful to us when matching you with a parent volunteer?

Location Information

All personal information will be kept confidential and will not be shared.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Hidden

Address*

Preferred Contact Method

Would you prefer that we:*

email you to arrange a time to talk by phone
text you to arrange a time to talk by phone

Email*

Phone*

Please share any additional information that may be helpful to us before connecting you with a First Call parent:

Consent Form

Consent*

I have reviewed the waiver and consent

Please review this waiver/consent.

EXPECTANT PARENT MUST CHECK BOX OR SIGN FORM
I understand that I will be speaking with a trained parent volunteer and that this conversation does not represent medical advice or professional counseling. The National Prenatal First Call Center does not provide advice in any way. My conversation(s) with a parent volunteer will be confidential and only a brief synopsis of our call(s) will be shared with the Family Support Team of the National Center to ensure individualized resources and supports are provided to me. My personal information will not be shared and will be kept confidential within the National Prenatal First Call Center.

If you have not heard from a First Call parent in 24 hours, you may email us at nationalfirstcall@mdsc.org

Lastly, we are curious how you heard of the National Prenatal First Call Center?*

Online search
Down Syndrome Diagnosis Network (DSDN)
Medical Conference
Facebook
Local Down syndrome organization
Another health care provider

Connect to a Parent Volunteer

Parent Connection Request

About You

About Your Pregnancy

Optional Additional Information

Location Information

Preferred Contact Method

Consent Form

About Us

Resources

Get Involved

Connect to a Parent Volunteer

Parent Connection Request

About You

About Your Pregnancy

Optional Additional Information

Location Information

Preferred Contact Method

Consent Form

About Us

Resources

Get Involved

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