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13 11 20

13 11 20

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Information & support

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Cancer Council SA offers a wide range of information and support services to people affected by cancer.

Referrer First Name:
Referrer Last Name:
Referrer Phone:
Referrer Email:
Referrer Organisation:
Referrer Title:
First Name:
Last Name:
Cancer Type:
Date Diagnosed:
Cancer Stage:
D.O.B.:
Street:
Suburb:
State:
Postcode:
Email:
Gender:
ATSI:
CALD Language:
Interpreter:
Phone:
Mobile:
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Privacy collection statement

Your privacy is as important to Cancer Council SA as it is to you. That’s why any personal information you give us will be treated with respect and in strict confidence. Personal information is collected to process donations, issue tax receipts and to send you updates. We may disclose your information to agents, contractors and third parties who provide services to us, and in doing so we take reasonable steps to ensure any information held by our service providers is protected. A full copy of our Privacy Policy is at wwwiugo.cancersa.org.au/privacy with details about how you can access and correct your personal information and how we handle any privacy complaints. Or call us on 1300 65 65 85 for more details about our commitment to your privacy.

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