Laura Allen
Executive Director
Do you know a child who needs our help?
We are glad you are here and found your way to our referral form. Whether you are a parent, physician, social worker, family friend, or other, you are in the right place to support a child in the Carolinas battling cancer.
We invite you to fill out the form below so we can make sure we can best meet your needs as quickly as possible. One of our Family Navigators will be in touch with you within 24-48 business hours.
CCP Referral Form
PLEASE NOTE: This form is ONLY for family members, friends, or a member of the community to fill out, and we will need a referral from the child's treatment center as well.
If you're a hospital social worker, please email the CCP Referral Form to Carla at [email protected] for any referrals or sign in to the SW Portal here.
If you have a child in mind who could benefit from our services, please use the form below. One of our team members will be in touch within 24-48 business hours.
Have more questions?
Feel free to contact Carla Fowler, Director of Family Services, at [email protected].
