. Let’s get to know you!

Hi CanTeen, My full name is
and I’m a .

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

I’m a

of
decent.
I was born on
.

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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.

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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

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Where do you live in New Zealand?

I live in
.
My nearest CanTeen branch is .

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What’s your current situation?

I’m currently .
My NHI number (if you know it) is .

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Tell us about your diagnosis.

In of
I was diagnosed with .
I currently receiving treatment.

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Do you have brothers or sisters?

I have brothers and sisters.

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Can you tell us more about your sibling?

My brother or sister

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

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

My parent or guardian says it’s for CanTeen to contact me.

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

Ok

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

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

My email address is . My phone number (including area code) is , and my postal address is, .

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How would you like us to contact you?

Please contact me by
.

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Who can we contact in case of an emergency?

The young persons emergency contact is their , whose name is . Their email address is email , and phone number (including area code) is .

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Who can we contact for in case of emergency?

's emergency contact is my , whose name is . Their email address is email , and phone number (including area code) is .

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

In the meantime, why not check out some stories from Canteeners, or learn more about how we can help.

What’s your family relationship with cancer?

I a brother or sister with cancer.

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Do you have other brothers or sisters?

I have brothers and sisters.

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Can you tell us more about your other sibling?

My other brother or sister

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

My sibling, , was diagnosed with . They passed away in of .

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

My sibling, ,
was diagnosed with .
They currently receiving treatment.

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What’s your family relationship with cancer?

I a parent or guardian with cancer.

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

My

, was diagnosed with . They passed away in of .

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

My , was diagnosed with .
They currently receiving treatment.

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

I’d like to refer .
They are

of decent,
born on
.

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Where does live in New Zealand?

lives in
.
Their nearest CanTeen branch is .

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What is 's current situation?

is currently .
Their NHI number (if you know it) is .

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Tell us about 's diagnosis.

In of was
diagnosed with .
They currently receiving treatment.

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Does have brothers or sisters?

has brothers and sisters.

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

's brother or sister

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

's parents or guardian says it’s for CanTeen to contact them.

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

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Please let us know how we can contact .

's email address is . Their phone number (including area code) is , and their postal address is .

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How would prefer to be contacted?

Please contact by
.

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CanTeen Stories

Real talk

Every CanTeener has a story to tell. Take a moment to hear them.

Abby

Abby

I never felt like the outsider or the 'cancer kid' at CanTeen

Amos

Amos

I got that sinking feeling

Bailee

Bailee

I can’t remember the last time I was this happy

Daniel

Daniel

“Cancer never really leaves you. It keeps you on edge.”

Dayna

Dayna

"I got back into everything too quick"

Dee

I can’t imagine my life without CanTeen

Erin

Erin

I’m such an outdoorsy person and being stuck in a room is horrible.

Gina

Gina

I NEVER EXPECTED TO BE DIAGNOSED WITH CANCER

Haley

Haley

CanTeen shaped who I am

Hayley

Hayley

I've met the most amazing people

Hayley

Being 21 and dealing with cancer

Hirini

Hirini

I knew my voice would be heard

Jacob

Jacob

Cancer took over my life at just twelve

Janine

Janine

“I didn’t realise how challenging life would be when I first got sick."

Jemma

Jemma

When cancer came into my life, a lot changed

Jenni

Jenni

The ultimate explorer

Lacie

Lacie

I didn't really understand what was going on

Lara

Lara

I now have a network of people who are there for me

Laura

Laura

CanTeen has been a big part of my cancer community

Lauren

Life is about the small things

Lauren

Lauren

I attended my first CanTeen event and never looked back

Leaton

Leaton

It was easy to make friends at CanTeen

Lola

Lola

He was the best older brother you could imagine

Matt

Matt

How do you say goodbye to your sister when you're only 20?

Matthew

Matthew

I don't have cancer do I Mum?

Matthew

Support that comes from everywhere

Meagan

Meagan

I met alot of people who knew what I was going through

Mike

Mike

Mike's life changed in a blink of an eye

Molly

Molly

CanTeen made me feel like im not alone

Pippa

Pippa

Cancer doesn’t end at remission

Rebecca

Rebecca

I had survived cancer. So why was I so afraid?

Rose

Rose

It all happened so quickly

Soni

Soni

Connecting with my peers

Stacey

Stacey

CANCER HIT OUR FAMILY TWICE

Summer

Summer

The kick start Summer needed

Teri

Teri

CanTeen has really helped me connect with people

William

William

"I felt like my parents would always be around to support and love me."

Zaynah

Zaynah

CanTeen helped me to open up