How to make a referral (health care professional)

To begin the registration process—or to make an enquiry—please submit the form below and we’ll email out the registration form.

If you are a social worker, cancer care or allied health professional you can refer a patient that meets the following criteria:

Must have a current diagnosis of cancer by an Australian Medical Specialist and be receiving specialist approved treatment.
Must have at least one child aged 12 years or under.

If you are a healthcare care professional or social worker please use the contact form below to request our registration form. This is the best and quickest way to get in touch with us. We appreciate your enquiry and will respond to you as soon as possible.

How we can assist you?*
- I'm a cancer-care professional and need to make a referral (please provide your contact details only)
- I would like to enquire about your service
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