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Cancer support referral

Cancer Council’s nurses provide information and support to people affected by cancer. If you have a patient or carer that needs support, please fill in the referral form below and one of our cancer nurses will contact them to see how we can help. In addition, please let them know that they, or anyone affected by cancer can call our nurses on 13 11 20 (cost of a local call), Monday to Friday, 9-5pm.

Health professional details

Patient details

  • share their personal, sensitive and health information with Cancer Council Victoria, to enable Cancer Council Victoria to contact them for the purpose of providing supportive care screening; and
  • Cancer Council Victoria providing information about the patient’s referral back to me as the referring health professional (which may include disclosing further sensitive and health information about the patient).

Date of birth

Operating hours are Monday to Friday 9am – 5pm.

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