Refer a Young Person to Canteen

If you know a young person 12-25 affected by cancer who needs support, please send us their details by filling out the form below. We will then contact them to answer any questions they may have.
To find out more about Canteen services and resources, click here.

  • Fields marked with * are required

  • Young person's details

  • Young Person's Contact Details

    Please enter at least one contact method
  • Please select that which best describes the young person's situation.
  • Parent or Guardian's name (if applicable)

  • Referrer's Details

  • Which of the following applies?
  • Which resources will be most useful (tick all that apply)
  • This field is for validation purposes and should be left unchanged.