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CANCER Who? Supporter Application
If you are a cancer patient or survivor in need of support please complete the application below so we can match you with a CancerWho Ambassador.
Date of Birth
How did you hear about the CANCER Who? Organization?
Are you currently going through treatment?
What is your Diagnosis?
Is this your first diagnosis or a recurrence?
Location where are you receiving treatment?
How would support from CancerWho impact your journey through cancer?
Is there anything you would like your ambassador to know before starting support?
Do you have a gender preference in the ambassador who will support you?
Doesn't matter - No preference
What kind of support do you need?
Emotional support over the phone
Quick Weekly Check-in calls
Emotional support in person
Therapeutic support by licensed therapist
Transportation to appointments
Attend doctor appointments
Motivational text messages
What do the words “Cancer Who?” Mean to you?
What inspires you to keep fighting?
Anything else you would like to share:
A copy of your responses will be emailed to the address you provided.
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