Refer someone to Cancer Hub

Cancer Hub

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Services
Get Support
About
FAQs

Refer someone to Cancer Hub

If you’re a health or services professional ready to refer someone seeking support, please complete the form below.

By providing us with this information, we can connect your patient, student or client with the support services that best meet their needs. Once you submit the form, someone from the Cancer Hub team will be in touch within 48 hours to discuss support options.

Cancer Hub is a collaboration between Canteen, Camp Quality and Redkite to help families impacted by cancer with children aged 0-25 more easily access the different practical and emotional support services they need.

If you have any questions about the services that Cancer Hub provides, please review our frequently asked questions.

Your Details

First Name

Last Name

Phone Number

Hospital/Organisation Name

Start typing to search for your organisation. If not found you may enter the full name of your organisation.

Organisation ID

Role

If you are not a health or service professional, please use our referral form for individuals or family and friends.

Has the person you are referring given their consent to this referral?

YesNo

Please provide information about your enquiry

Details of person being referred

First Name

Last Name

DOB (DD/MM/YYYY)

Is the person you are referring under 16?

YesNo

Phone Number

Country

State

Suburb

Postcode

Is the person you are referring Aboriginal and/or Torres Strait Islander?

Does the person you are referring require a language interpreter?

YesNo

Which language do they need an interpreter for?

Is the person you are referring a:

Young personParent or carerOther relationship to child/young person

Please select the option that best describes the person you are referring

AuntUncleGrandparentExtended family memberFriendOther

Please specify

Please select the option that best describes the cancer experience for the person you are referring

I have cancer I survived cancerMy sibling has cancer My sibling survived cancerMy sibling died from cancerMy parent/carer has cancerMy parent/carer survived cancerMy parent/carer died from cancerOther

Please select the option that best describes the cancer experience for the person you are referring

I have cancer I survived cancer My child has cancer My child survived cancerMy child died from cancerMy partner/spouse has cancerMy partner/spouse survived cancerMy partner/spouse died from cancerOther

Please provide information about the cancer experience of the person seeking support

Please provide any additional information about the support that the person you are referring needs

Who should we contact regarding support options?

The person being referred

MeSomeone else

Who should we contact regarding support options?

MeParent/guardian of the person being referred

Other Contact/Parent or Guardian Details

Please provide the details of the other person to be contacted about the support that Cancer Hub offers.

For a young person under 16, in order to process this referral please provide the contact details of their parent/guardian for additional contact regarding support options.

First Name

Last Name

Relationship to the person seeking support

Phone Number

How did you hear about Cancer Hub?

If Other, please enter how you heard about Cancer Hub

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Socials

Canteen Australia
Camp Quality
Redkite

Call Cancer Hub

1800 431 312

Acknowledgement of Country

We acknowledge Aboriginal and Torres Strait Islander peoples as Australia’s First Peoples and sovereign Custodians of this land. We pay our respects to Elders past, present and emerging. We are committed to providing inclusive and appropriate support for First Nations young people, their kin and community impacted by cancer. First Nations peoples are respectfully advised this website may contain images, names or stories of people who have passed away. Ngalaya (Dharawal for ally or friend in battle), is an artwork commissioned by Canteen created by Kamilaroi and Jerrinja woman and artist Jasmine Sarin.

Diversity and Inclusion

We are guided by our values and commitments to ensure that everyone at Cancer Hub feels respected, included and safe. We welcome the LGBTQI+ community and people from all cultures, backgrounds and abilities.

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Refer someone to Cancer Hub

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