Connect with a
Cancer System Navigator

Please complete the form below to connect with one of our navigators.

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Type of Referral:*

Self-Referral

Referral made by Health Professional:

Name of referring Health Professional

Organization of referring Health Professional

Contact Info of referring Health Professional

Client Information*

Check all that apply:*

Living with cancer or survived cancer

I am a caregiver

Family member/friend

I am grieving the death of a loved one

Other

Postal Code*

Phone Number*

Email*

I identify as:

Age Range

Preferred language of initial contact*

English

French

Do you require an interpreter for the initial contact, if so, in which language?

Do you require any other accessibility supports for the initial contact? If so, please explain:

How did you find out about the Cancer System Navigation Program?

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Comments

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Cancer System Navigators

Mental Health Programs

Exercise + Movement

Managing Symptoms + Side Effects

Nutrition

Courses + Workshops

Social + Peer Support

Children, Youth + Families

Young Adults

Caregivers

Program Calendar

Aurora Ball

Fight for the Cure

Laugh for the Cure

Lemonade Standemonium

The Cancer Care Champions Breakfast

Host a Fundraiser

Upcoming Events

Book our Space

Tribute Giving

Donate Today

Monthly Giving

Host a Fundraiser

Gifts of Securities

Donate a Vehicle

Legacy Giving

Volunteer your Time

Transforming Cancer Care

Our Story

Our Team

News

Careers

Survivors Park

Financial Statements

Connect with a
Cancer System Navigator

Please complete the form below to connect with one of our navigators.

Cancer System Navigators

Mental Health Programs

Exercise + Movement

Managing Symptoms + Side Effects

Nutrition

Courses + Workshops

Social + Peer Support

Children, Youth + Families

Young Adults

Caregivers

Program Calendar

Aurora Ball

Fight for the Cure

Laugh for the Cure

Lemonade Standemonium

The Cancer Care Champions Breakfast

Host a Fundraiser

Upcoming Events

Book our Space

Tribute Giving

Donate Today

Monthly Giving

Host a Fundraiser

Gifts of Securities

Donate a Vehicle

Legacy Giving

Volunteer your Time

Transforming Cancer Care

Our Story

Our Team

News

Careers

Survivors Park

Financial Statements

Connect with aCancer System Navigator

Please complete the form below to connect with one of our navigators.

Connect with a
Cancer System Navigator