Join the CWP

Become a member of the Cancer Wellness Program

The Cancer Wellness Program at Greenslopes Private Hospital is committed to equipping patients and their families with the advice, resources and support they need for a smoother pathway through treatment and beyond.

The Cancer Wellness Program is proudly supported by Gallipoli Medical Research Foundation (GMRF).

Please refer to our privacy policies in relation to the collection of personal information:

Greenslopes Private Hospital Privacy Policy https://www.greenslopesprivate.com.au/Coming-to-Hospital/Privacy-Policy

GMRF Privacy Policy https://www.gallipoliresearch.com.au/privacy-policy/

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* 1. Are you receiving cancer treatment at GPH

Yes

Other (please specify)

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* 2. Contact Details

First and last name

Phone Number

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* 3. D.O.B.

Date

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* 4. What is your diagnosis

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* 5. Who is your treating Dr at GPH?

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* 6. At what email address would you like to be contacted?

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* 7. Would you like to receive updates from GMRF who fund this program?

Yes

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* 8. I consent to GPH and GMRF storing my email address for contact purposes

Yes

Join the CWP

Become a member of the Cancer Wellness Program

Question Title

* 1. Are you receiving cancer treatment at GPH

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* 2. Contact Details

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* 3. D.O.B.

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* 4. What is your diagnosis

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* 5. Who is your treating Dr at GPH?

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* 6. At what email address would you like to be contacted?

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* 7. Would you like to receive updates from GMRF who fund this program?

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* 8. I consent to GPH and GMRF storing my email address for contact purposes

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* 9. Signature