Cancer Coach Application

Complete this application if you are interested in being a Cancer Coach. Your application will be reviewed and you will be contacted by our Cancer Coach Coordinator to be interviewed and to discuss the next steps in the process.

Personal Information

Your biologically assigned gender *

Treatment Information

Answering these questions will enable us to place you most effectively with patients that are having similar experiences to yours.

Have you had any recurrences? *

Stage *

What types of treatment were involved in your care? *

Activities & Involvement

Are you a current Roswell Park volunteer? *

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