Patient Support Grant Application Form

The Nelson and Tasman Cancer Society recognises that people with cancer often have to cope with additional costs as a direct result of their illness and that often this leads to financial hardship.

Cancer Support in Nelson/Tasman

Local Cancer Support Groups
Cancer Education
Support Grants
Counselling
Fitness & Lifestyle Support
Family Support
Other Support

Fill out our Patient Support Grant Application Form

Patient Support Grant Application Form

  • Select date MM slash DD slash YYYY

  • Applicants Details

  • Who is making this application?

    Name and position of person submitting this application on behalf of applicant: (Must be a health professional / social worker / Cancer Society staff member)
  • Please confirm the proposed recipient of this Grant is aware of this application and that all information is kept securely in accordance with the Privacy Act 1993:
  • 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