Critical Assist Referral Form

Critical Assist aims to provide assistance to Queenslanders diagnosed with cancer and experiencing the most severe financial hardship and at risk of not participating in their cancer treatment.

The aim of the service is to support eligible clients in accessing affordable accommodation and transport through the provision of advocacy, referral and financial support.

Before completing the referral, ensure you have read the Critical Assist Guidelines.

This referral form must be completed by a health professional on behalf of the client. 

You will receive an email confirming your successful submission of a referral to Critical Assist. If you do not receive this email, check your form for errors and re-submit.

Additional Assistance

Cancer Council Queensland is an agent for the Telstra Bill Assistance Program (TBAP).  TBAP is a national program that is offered to Telstra account holders who are experiencing financial hardship and having trouble paying their Telstra bill.  If your client is a Telstra account holder, they may be eligible for assistance under this program.  To learn more about referring your client to this program, please refer to the TBAP Referral Guidelines.

If you are experiencing technical issues, please email practicalsupport@cancerqld.org.au or phone 13 11 20 and we’ll be happy to assist.