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American Cancer Society Cancer Referral Services

If you or a family member has been diagnosed with cancer, the services and information provided by the American Cancer Society may be valuable in dealing with your cancer experience. Complete the attached form and submit to the American Cancer Society for service referral.

Upon receipt of the confidential form, you will receive patient information, including information about the programs and services available through your American Cancer Society.

In the meantime, if you have questions about cancer or the American Cancer Society’s services, they are available 24 hours a day, seven days a week. Please call 1-800-227-2345 or visit