PLEASE NOTE: we have recently made some amendments to this form in order to improve the way we collect information and create a more streamlined process for users of this referral form. This form was designed with the intent to ensure that all essential information is collected when the Leukaemia Foundation receives a request for accommodation support. The Leukaemia Foundation has finite resources with which to provide support to people living with a blood cancer through its accommodation services. This assessment process allows us to assess all requests, so we can ensure our resources are being utilised to assist those most in need. Please note 48 hours notice is required, if your request is for a date within 48 hours, please contact us directly. Please ensure all fields are completed and should you have any questions please contact us at firstname.lastname@example.org.