Your Voice. Your Care: Be In The Know (YES)
Join IPUL and TCOM for an interactive training just for youth!
We'll break down the CANs so YOU can understand why providers acsk the quesitons they do, what they're rating, and how it all helps YOU
Taking Place
Monday, June 15, 2026
12:000 PM MT (noon)
Online or In Person!
If you're under 18 years old:
A parent, guardian, or legally responsible adult must complete the required adult sections of this form. Please have them review and fill out those portions before you finish your registration.
Some Quick Questions
This survey helps us understand what you already know and what you want to learn. There are
no right or wrong answers. Your responses help us make this training better for youth.
Will you be attending:
In Person
Virtually via Zoom
Do you need any accommodations to fully participate in this training?
Is there a specific question you hope gets answered?
Are you currently involved in YES services (or think you might be)?
Yes
Maybe / I’m not sure
No
Prefer not to say
How much do you feel adults include you in decisions about your care or services?
A lot. I feel like my voice matters
Sometimes
Not very much
I’m usually not included
I’m not sure
Which of these do you feel confident about? (Check all that apply)
Speaking up about what helps me
Asking questions in meetings
Saying when something isn’t working
Knowing who is on my care team
Understanding my services
I don’t feel confident about these yet
Adult Information
Are you a:
Parent
Professional
First Name:
Last Name:
Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaskan Native
Other
Unknown
Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Phone Number:
Email Address:
Join Mailing List
If you would like to be on IPUL's mailing list check this box.
Mailing Address
Mailing City
Mailing State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
This address is my
Home
Work
Professional Information
Organization Name:
My Title:
Phone Number:
Only if different from above
Email Address:
Only if different from above
Youth Information
Please only enter information for an individual person, you will be able to add more below if needed.
Child's First Name:
Child's Last Name:
Child's Gender:
Female
Male
Child's Birthdate:
Child's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Youth Information (2)
Please only enter information for an individual child, you will be able to add more children below.
Child 2's First Name:
Child 2's Last Name:
Child 2's Gender:
Female
Male
Child 2's Birthdate:
Child 2's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 2's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 2's Diagnosis:
Do You Have Another Child to Enter?
Yes
No
Youth Information (3)
Please only enter information for an individual child, you will be able to add more children below.
Child 3's First Name:
Child 3's Last Name:
Child 3's Gender:
Female
Male
Child 3's Birthdate:
Child 3's Demographics:
Please select...
White or Caucasian
Black or African American
Asian
Pacific Islander
American Indian or Alaska Native
Other
Unknown
Child 3's Ethnicity:
Hispanic or Latino
Non-Hispanic or Non-Latino
Other
Child 3's Diagnosis:
If you have more than three children that you need assistance with, our Parent Education Coordinator will take your information directly.
Training Information
Incredibly Important Back End Stuff
(Hidden from person filling form, but
needs to be set up when building the registration or everything will be for naught and you will spend several days trying to fix your data WITH WOE IN YOUR HEART AND A POX UPON YOUR HOUSE)
Funding Source
separate with semicolon and put in
Default Value
under
Options
EXAMPLE
:
MCHB F2FHIC; PTI
(THESE NEED TO MATCH SALESFORCE OR PAIN WILL RESULT)