Return Referral to:
CCT Senior Support Officer 
Phone: 1300 656 585
Email:                                                                                                                                             
Southern Tasmania	supportservicessouth@cancertas.org.au                                                      
Northern Tasmania	supportservicesnorth@cancertas.org.au                                                        
North West Tasmania	supportservicesnw@cancertas.org.au	
Name:	<PtFullName>	Gender:	<PtSex>		
Date of Birth:	<PtDoB>	Age:	<PtAge>	Aboriginal / Torres Strait Islander?	<Aboriginal or Torres Strait Islander?>		
Address:	<PtAddress>		
Phone:	(M)	<PtPhoneMob>	(H)	<PtPhoneH>	Email:	<PtEmail>		
Convenient time to call:		Message able to be left?			
	
¨	Patient/Client:		¨	Carer/Family Member:			
¨	General/Public:		¨	Health/Allied Health Professional:			
Cancer Type:			
Treatment:			
Reason for Referral:			

			
	
Consent:	
Referrer’s Name:	<UsrName>		
Organisation/Position:			
¨	I certify that the client has given verbal consent to me to provide Cancer Council Tasmania with their personal details to be contacted by CCT Support Services staff.	
Signature:		Date:	<TodaysDate>		

Cancer Council Tasmania Support Services
From three Support Centres, Cancer Council Tasmania offers a range of face to face, phone, or email-based support during business hours, as well as evidence-based information resources at no cost.  There are also a range of DVD’s and books available for loan.	
South
15 Princes Street,
Sandy Bay 7005

(Includes South of Campbell Town and South of Bicheno on the East Coast)	

North 
69 Howick Street, Launceston 7250

(Includes Flinders Island, the East Coast North of Bicheno and East of Deloraine)	

North West
Suite 2, 45 Best Street 
Devonport 7310

(Includes West from Deloraine, West Coast and King Island)	

Contact for all Support Centres

1300 656 585
www.cancertas.org.au	

	Psycho-social support
Cancer Council Tasmania offers a wide variety of support options for those affected by cancer including:
•	One to one support: visit or phone a Support Centre
•	Support groups in regional and urban areas
•	Hospital visits on request
•	Cancer Council 13 11 20 to speak to a Nurse at the cost of a local call
•	Cancer Connect to receive phone support from a trained volunteer who has had a similar cancer experience.
Children, Adolescents and Young Adults
Cancer Support for under 25’s is a state-wide program supporting Tasmanian families of children, adolescents and young adults with cancer and survivors of childhood cancer.  This includes emotional support, information and resources, financial assistance and Educational Scholarships for 16 - 25 year-olds.
Workshops
•	Group Programs, including Complementary Therapies, Art Therapy, Walking Groups.
Practical Support
•	transport2treatment (t2t): assisting cancer patients to travel to and from treatment at no cost.
•	Financial Assistance Scheme: assists patients currently undergoing treatment or receiving palliative care
•	Wig Libraries in each region
•	ProBono: legal, financial, small business and HR advice from professionals.	
Information correct as at 17 August 2018.