Referrals

How to refer a young person

Before completing the Referral Form, please read this information about CanTeen.

You can refer a young person to CanTeen if they are aged 13 to 24 and any of the following…

They have a cancer diagnosis
They had cancer as a child and have some late effects relating to cancer, treatment or just getting life back on track
They have a sibling with a cancer diagnosis
They have a sibling who had cancer as a child and who is coping with late effects related to cancer or treatment
They have a parent with a cancer diagnosis
They have lost a sibling or parent to cancer

To refer a young person

Click here to fill out the referral form. After completing the membership form, you will receive an email acknowledging receipt of your referral.

What happens next

A Youth Support Coordinator will make contact with the young person or their parent or guardian within a week and arrange to meet them to discuss how CanTeen can help.

The Youth Support Coordinator will then get back to you to confirm the support we can provide so that this can be integrated into the overall support plan for the young person.

If you have any questions about whether to refer a young person please call us on 0800 CanTeen (226 8336).

. Let’s get to know you!

Nice to meet you . Tell us a bit about yourself!

CanTeen is for young people who are 13 years old or over. We’d love to have you when you turn 13! For now, we’d recommend you get in touch with The Child Cancer Foundation.

CanTeen is for people 13-24 years old. But there are lots of other support options for adults. For more info or to get in touch please email info@canteen.org.nz

Where do you live in New Zealand?

What’s your current situation?

Tell us about your diagnosis.

Do you have brothers or sisters?

Can you tell us more about your sibling?

Due to their age, are also eligible to join CanTeen.

Because you’re under 18, we need to know it’s OK to contact you.

Oops. You’ll need permission from a parent or guardian. Please come back to this form when you’re ready.

Thanks . Is there anything else you’d like to tell us about yourself? For example, if you have any visual impairments or medical implants?

Please let us know how we can get in touch with you.

How would you like us to contact you?

Who can we contact in case of an emergency?

Who can we contact for in case of emergency?

Thanks . You’re all done, we’ll be in touch soon!

What’s your family relationship with cancer?

Do you have other brothers or sisters?

Can you tell us more about your other sibling?

We’re sorry for your loss. Please tell us a little about them.

Tell us about your sibling living with, or who survived cancer.

What’s your family relationship with cancer?

We’re sorry for your loss. Please tell us a little about them.

Tell us about your parent living with, or who survived cancer.

Nice to meet you . Who would you like to refer to CanTeen?

Where does live in New Zealand?

What is 's current situation?

Tell us about 's diagnosis.

Does have brothers or sisters?

Can you tell us more about 's sibling (please fill in as much as you can)?

Because is under 18, we need to know it’s OK to contact them.

Thanks . Is there anything else you’d like to tell us about ? For example, if you have any visual impairments or medical implants?

Please let us know how we can contact .

How would prefer to be contacted?

Oops!

How to refer a young person

You can refer a young person to CanTeen if they are aged 13 to 24 and any of the following…

To refer a young person

What happens next

CanTeen is for young people who are 13 years old or over.
We’d love to have you when you turn 13!
For now, we’d recommend you get in touch with The Child Cancer Foundation.

CanTeen is for people 13-24 years old.
But there are lots of other support options for adults.
For more info or to get in touch please email info@canteen.org.nz