Get Started with MyCancerJourney
The MyCancerJourney service includes the guidance and assistance of a patient advocate - board certified and specialized in cancer care. They will help you understand your diagnosis and your treatment options, answer questions, advocate for your needs, and ultimately help ensure you get the best care for you - tailored to your specific situation and goals. MyCancerJourney is offered at no cost through several providers and health plans. For those not covered, a self-pay option is available. Once you complete the form below, your Patient Advocate will contact you within one (1) business day. For more information, please visit mycancerjourney.com
I am requesting this consult for
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Myself
My spouse
My dependent
First and Last Name
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Employer
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Surest Group Number
Surest Member ID Number
Date of Birth
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Best Contact Phone Number
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Best Contact Email Address
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Preferred method of communication
Phone (recommended)
Email
Text
Best time to contact the patient
Morning
Afternoon
Evening
Other
Cancer you have been diagnosed with
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Please Select
Bladder
Breast
Cervix
Colon
Head and Neck
Kidney
Liver
Lung
Ovaries
Pancreas
Prostate
Rectum
Stomach
Thyroid
Uterus
Other / None of the Above
Please verify that you are human
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