Support Starter Kits – Enrollment Form

Thank you for your interest in the Support Starter Kit program. Whether you're enrolling yourself or someone else, we're glad you're here. This form should take about 5–10 minutes to complete.

Before You Begin

Throughout this form, "young adult" refers to the person diagnosed with cancer enrolling in the Support Starter Kit program.

Please have the name, email address, and mailing address (if known) for each invited supporter before you begin. To protect the young adult's privacy and avoid surprises, please only invite supporters who already know about their cancer diagnosis and are expecting an invitation email from b-present.

If you're completing this form on someone else's behalf, please make sure the young adult has given you permission to enroll them in the program.

Invite up to three supporters to participate in the Support Starter Kit program.

We'll email each invited supporter with information about the program and ask them to confirm their mailing address.

Please only invite people who:
• are aware of the diagnosis
• know they'll receive an invitation email from b-present

We only use this information to send Support Starter Kits and program communications.

For each invited supporter, please provide the name, email address, relationship, and mailing address (if known)

Important: Please only invite people who already know about the young adult's cancer diagnosis and are expecting this invitation.

Please provide information for another invited supporter.

Please provide information for another invited supporter.

These questions help us better understand the young adult's experience so we can continue improving the Support Starter Kit program.

These questions help us create more inclusive programs and better understand who we're serving.

We'll only contact you if we have questions about this enrollment or kit delivery.