Client Registration Form

Nau mai haere mai - We support anyone affected by cancer –patients, family /whānau, friends and colleagues. We can help you, or someone you care about, understand about cancer, how to talk with others, and find the support most suitable for you.

Please note: as we are a non-government organisation, we are not automatically informed of new people diagnosed with cancer, so we ask you to fill in this form to let us know how we can help. Please contact us or email us if you would like more information.

Cancer Support in Nelson/Tasman

Local Cancer Support Groups
Cancer Education
Support Grants

Counselling
Fitness & Lifestyle Support
Family Support
Other Support

Fill out our Client Registration Form

Self Registration Form

  • Contact Details

  • Select date DD dash MM dash YYYY

  • What information would you like to receive?

  • I would like to receive information regarding support groups and events
  • I would like to receive this newsletter
  • Your information and records of any support received from the Cancer Society, will be kept on our secure database in accordance with the Privacy Act. We do not share your information unless we have your consent to do so for a specific purpose.
  • Select date DD slash MM slash YYYY
  • Note: Anyone accepting a counselling grant is registered as a Cancer Society member
  • This field is for validation purposes and should be left unchanged.

Find out more about our support services

If you would like to find out more about our individual support services or join a support group please phone the Centre(03) 539 1137 or email us.

Contact us