Group Inquiry | Facing Cancer Together

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Programs & Services
- Join a Group
- FCT Holiday Closures
News
FAQ
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About Us
Programs & Services
- Join a Group
- FCT Holiday Closures
News
FAQ
Creative Corner
Resources
Contact Us
Donate

Group Inquiry Form

Please fill out the form below if you are interested in joining one of our groups. A member of the FCT team will contact you regarding the intake process. If you have any questions about the form and require assistance, you can contact us at 617-332-5777. Please note that FCT's clinicians are only licensed to provide support for individuals who live in Massachusetts.

Name*
First Last
Phone*
Email*
Address*
Please note that FCT only provides support to individuals who live within the state of Massachusetts.

Street Address Address Line 2 City State ZIP Code
Date of Birth*
Month
Day
Year
Gender*
Pronouns
Race*
This information is used for funding applications.
- American Indian or Alaska Native
- Asian
- Black or African American
- Native Hawaiian or other Pacific Islander
- White
Are you Hispanic or Latino?*
This information is used for funding applications.
- Yes
- No
Contact preference*
Please let us know the best way to reach you.
- Email
- Phone
- Text
How did you hear about FCT?*
Are you familiar with Zoom?*
- Yes
- No
Groups*
Please indicate which of the following groups you are interested in joining.
- Cancer Support Group
- Caregiver Support Group
- Adult Bereavement Group
- Young Adult Bereavement Group
- Multiple Myeloma Networking Group
- Chinese Brush Painting
- Writing for Wellness
Additional Information
Please feel free to let us know if you have any questions or other information you would like to share with us.