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Call for Information & Support

Health professionals

You know that a person with cancer isn’t just a patient. So do we.

Together, we can help West Australians get the tailored emotional, practical and physical support they need to stop cancer controlling their life

If you have a patient or carer that is impacted by cancer, 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, Monday to Friday, 9 – 5pm.

Health professional details


Patient details

Is this request for a patient or a family member / carer?
I have the consent of the patient / carer / family member (whichever this request relates to):
DD slash MM slash YYYY
Preferred method of contact
DD slash MM slash YYYY
Type of support that the individual requires
We need to collect personal information to process this referral, communicate with you and conduct normal business. By providing your personal information, you agree that your information will be used and disclosed by Cancer Council WA in accordance with our Collection Statement and Privacy Policy.