Request a Peer Mentor

Our trained Peer Mentors have faced a cancer diagnosis firsthand — the fear, the uncertainty, the hard days and the hopeful ones. They're here to truly listen, share what helped them, and remind you that you are not alone.

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Your mentorship journey starts with a 15-minute call

Once you fill out this form, our team will personally reach out to schedule your required 15-minute introductory call. 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.

About you

First Name *

Last Name *

Email *

Phone *

Phone Type

Time Zone *

Location (City & State)

Birthdate/Current Age *

Preferred Language(s) *

Ethnicity *

How should we reach you?

How did you find us? *

About your diagnosis

Your cancer diagnosis *

Your age at diagnosis *

What would you most like to talk about with your Peer Mentor? There’s no right or wrong answer. You might share what’s weighing on you, what you hope to hear from someone who’s been through it, or what kind of conversation would feel supportive and helpful *

Are any of the below life circumstances currently impacting your 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, you're taking a meaningful step toward the support you need.

I consent to Cancer Hope Network reaching out to me. I understand they will reach out to me directly to start the matching process.