Hopeful Hearts - Request a Peer Mentor

Your mentorship journey starts with a 15-minute call

Once you submit, our team will personally reach out to schedule your required 15-minute introductory call. It's a warm, no-pressure conversation. This is your chance to tell us a bit about your situation so we can find the right match for you. This call is a required step before your mentor match is finalized.

All information provided below is kept strictly confidential and will not be shared with anyone outside of Cancer Hope Network.

First Name *

Last Name *

Email *

Phone *

Phone Type

Time Zone *

Location *

Preferred Language(s) *

Relationship to person diagnosed *

Child's Current Status

Ethnicity *

Child's Age at Illness

Child's Cancer Diagnosis *

Please share a bit about your child's cancer diagnosis and any specific challenges or experiences you would like to discuss with a peer mentor. *

Are any of the below life circumstances currently impacting your family's cancer experience?

Please select all that apply. This additional information is helpful to our team as we work to find you the best match.

By submitting this form, you are consenting to Cancer Hope Network contacting you. Our team will reach out to schedule an intro call and start the matching process.

I accept the Terms and Conditions