Online Event Registration Form - Hunter Breast Cancer Foundation

HBCF Wellness Hub Registration

Your Name*

First Last

Your Email*

Your Phone*

Are you undergoing active treatment for breast cancer?*

Please indicate your treatment status here.

I am undergoing active breast cancer treatment

I have had breast cancer but now have no evidence of disease (remission)

I do not have breast cancer

Name of Doctor or Treatment Centre*

Are you located in the Hunter Region of NSW Australia?*

Hunter Breast Cancer Foundation supports Hunter residents with breast cancer and their families. If you are located outside the Hunter Region, please contact your local support service.

I am a resident of the Hunter Region

I live outside the Hunter region

Your Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Access Request*

I request access to HBCF Wellness Hub. I acknowledge that this access is for my personal use only and I may not share log in details or content with others without prior permission from Hunter Breast Cancer Foundation.

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HBCF Wellness Hub Registration