Referral Form

Help us eliminate isolation!

Young Adult Cancer Canada (YACC) is a national not-for-profit organization that provides digital, local, and national programs for young adult cancer patients and survivors diagnosed between the ages of 15-39 and aged between 18-39 years old. YACC also offers services to those supporting young adults living with cancer as long as they are aged between 18-39.

If you are — or work with — a young adult who is eligible to our services, please fill out the form below and we will be in touch with more information about relevant services.

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