Online Support : Realshare

We NEVER share your details with anyone - anything you share with us is private and confidential.

Address

How do you prefer to be contacted?EmailMobileFacebook

Youth Cancer Trust run a secure Facebook group for our guests. If you would like to be added to the Facebook group, please add your Facebook profile or Facebook email address below

Facebook Contact

If you are under 18, please ask your parent / guardian to sign to give their permission for you to access our Facebook group.

Emergency Contact

We take the wellbeing of our guests very seriously. Should we have any concerns about your health or wellbeing whilst participating in our online programme, we request that you can please provide us with an emergency contact. If you are under 18 this must be your parent / guardian.

Medical Information

Diagnosis

Diagnosis

Current Medical / Health Issues

In this section, please describe how your current diagnosis and treatment affects you. Also include any other health issues we need to be aware of.

Daily Living

Please complete this section to let us know about anything else that may impact on your ability to participate in activities and how we can support you.

Do you have any problems communicating verbally?YesNo

Do you have any hearing or visual impairment?YesNo

Do you have any mobility or dexterity needs?YesNo

Do you have any breathing problems such as asthma?YesNo

Do you have any dietary requirements or food allergies?YesNo

Have you been diagnosed with any behavioural / emotional issues which may affect participation in online activities?YesNo

Have you been diagnosed with any behavioural disorders such as ADD or ADHD?YesNo

Have you been diagnosed with a learning disability?YesNo

Do you experience brain fog or trouble remembering things?YesNo

Do you experience fatigue?YesNo

Activities and Support

What activities and support are you interested in?

We are open to your ideas and suggestions and will try our best to make them happen where possible. Please use the box below to tell us any ideas for activities/ support you would like to see included.

Criminal Convictions

Do you have any criminal convictions?

Terms and Conditions

Unless specifically stated, the online activity and support programme, and secure Facebook group is for Youth Cancer Trust guests only.

The term 'guest' refers to anyone meeting our criteria:

'young people aged 14 to 30 living with cancer or any malignant disease from anywhere in the UK and Irish Republic or who are patients of any UK hospital. You can also join our program if you have been in remission for up to 5 years, or are living with the late effects of having had cancer as a teenager.'

At our discretion, we are also currently accepting applicants meeting the above criteria who are over 30 years of age.

All guests participating in our online programme agree to at all times treat peers and staff respectfully and courteously, or may be asked to leave the programme.

All content in the secure group including guest’s comments, photos, zoom recordings and zoom links are strictly to remain within the group only and not to be shared publicly, unless permission has been granted from the individual or group moderators.

Youth Cancer Trust will not tolerate any bullying or intimidating behaviour and reserve the right to remove and block anyone from accessing the secure group and activities if they do not adhere to the above conditions.

Should guests experience any bullying from peers or they have any concerns / grievances please report to one of the group moderators immediately.

Guests participating in physical activities hosted by Youth Cancer Trust must seek advice / permission from their GP first if they are not currently physically active.

Agreement

I agree to adhere to the above terms and conditions at all times. I understand that failing to do so may result in me being removed from the group.

Other

How did you hear about us?