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Cancer stories and news

Share your story with us

We often have opportunities to use stories about people’s cancer experience to help us with the work we do.

If you have been affected by cancer and would like to share your story with us, please fill in the form below and we will be in contact to discuss it further.

First name

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Last name

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RequiredPlease enter a valid email address

Phone number

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Suburb

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Date of Birth

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Are you a

Cancer patient or survivor
Carer
Other (please specify)

Required

If other, please specify (optional)

What type of cancer have you been diagnosed with? (optional)

When were you diagnosed with cancer? (optional)

Can you summarise your cancer experience? (optional)

Do you have a family history of cancer? (optional)

Who else in your family has been diagnosed with cancer? (optional)

Who did you care for? (optional)

Can you describe the experience of caring for someone with cancer? (optional)

Can you explain how you and your loved ones have been impacted by cancer? (optional)

Have you or your loved ones used Cancer Council’s information or support services?

Required

Which information or support services have you or your loved one used? (Select all that apply) (optional)

Phone support (such as Cancer Council 13 11 20)
Cancer Council Victoria website
Holiday break program
Wig service
Support group
Legal or financial advice
Cancer information booklets
Other (please specify)

If other, please specify (optional)

Have you participated in media interviews before?

Required

Please summarise your media experience. (optional)

Is there any other interesting information about you or your family that you'd like to share with us? Write or upload your story here

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Upload your story (optional)

Filename can contain only alphanumeric characters and space .

Do you fundraise or volunteer for a Cancer Council Victoria event or campaign?

Required

Which campaign/s are you registered for? (optional)

Australia's Biggest Morning Tea
Daffodil Day
Girls' Night In
I Will For Cancer
Relay For Life
The Longest Day
Walking Stars
Other

If other, please specify (optional)

If relevant, please describe your event. (optional)

By completing this form and sharing your story with us you have provided Cancer Council Victoria with your personal information. We may also collect further personal information about you through our ongoing communication.

Cancer Council’s Privacy Policy and Collection Statement contains general information about how we will handle and hold your personal information, and how you can contact us to seek to access or correct your personal information or make a complaint.

In addition to the uses and disclosures described in our Privacy Policy and Collection Statement, we will use and disclose your personal information to contact you to find out more about your cancer experience and to see what activities you’d like to be involved in.

By submitting this form, I agree to Cancer Council Victoria collecting and holding my personal and health information in accordance with its Privacy Policy and Collection Statement, and using such information to contact you about your cancer experiences.

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Aboriginal communities

Charity ABN: 61426486715

Cancer Council Victoria would like to acknowledge the traditional custodians of the land on which we live and work. We would also like to pay respect to the elders past and present and extend that respect to all other Aboriginal people.

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