Be Matched With A Volunteer

“I can’t begin to tell you how comforting it was and is to have someone a phone call away.”

If you have recently received a cancer diagnosis and would like to receive the support of a Friend for Life volunteer, please complete and submit the form below. We ask that you describe your situation in as much detail as possible (type of cancer, stage, chemo drugs, alternative therapies, etc.) so that we can make an appropriate match. You may even include hobbies and interests. Please include what is most important to you from the match (particular diagnosis, chemo type, life situation, etc.). If you are a family member, friend or co-worker who would like to receive the support of one of our volunteers, please provide what you know about the patient's diagnosis, your relationship to that person, and what is concerning you at this time.

Once you complete the form, click the "Submit" button, which will send your information to Friend for Life staff. All personal information will be provided only to Friend for Life staff and to the volunteer(s) with whom you are matched.

Please also include how you found out about us in the Details box below.


Name:
Age:
Email:
Phone:
Zip Code:
Message:
Type VOLUNTEER in the blank: