Home / Get Involved / Peer-To-Peer Peer-To-Peer Peer-to-Peer Navigators are lung cancer survivors or supporters (family members and caregivers) who have walked the lung cancer path. They know how difficult it can be dealing with lung cancer. Peer-to-Peer Navigators are volunteers who can mentor; offer encouragement, advice, experience, and hope to those newly diagnosed or anyone needing additional support through a one-on-one personal connection. Peer-to-Peer Navigators can be a vital link for a patient by being an empathetic supporter and navigator through the logistics and emotions of living with lung cancer. If you have been affected by lung cancer and would like to be matched with a Peer-to-Peer Navigator, or if you are a patient, survivor or supporter who would like to serve as a Peer-to-Peer Navigator, please fill out the form below or contact us at info@lungcancercanada.ca All information provided is kept confidential and is never shared with anyone except your support partner. This program is a free service from Lung Cancer Canada. Peer to Peer Support Request Form First Name: Last Name: Age: Gender: MaleFemale Address: Address 2: City: Province/State: Postal Code: Country: (select country) Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovinia Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (Dem. Republic) Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey and Alderney Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Island of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (Democratic Republic of) Korea (Republic of) Kosovo Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua-New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Re union Republic of Dominica Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay USA Uzbekistan Vanuatu Vatican (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Phone Number: Email: I am a: PatientCaregiverOther If other, please specify: I am seeking: to provide peer to peer support to othersto receive peer to peer support from a mentor Seeking support for: General SupportClinical TrialsTreatment InformationOther Check all that apply If other, please specify: Availability: PhoneEmailBoth Languages spoken: EnglishFrenchMandarinGermanItalian Others: Please list any other languages Diagnosis Date: Date and timeCalendar Age at Diagnosis: Type of Lung Cancer: Stage at Diagnosis: Current Stage: Gene Mutations: EGFRALKPDL 1 ExpressionOther If other, please specify: Previous Treatment: SurgeryChemotherapyRadiationTargeted TherapyImmunotherapyNone Please List: If checked, please list names of all previous chemo, targeted and immunotherapy drugs. Current Treatment: SurgeryChemotherapyRadiationTargeted TherapyImmunotherapyNone Please List: If checked, please list names of all previous chemo, targeted and immunotherapy drugs. Experience with: Obtaining a second opinionManaging financial implications of cancerBeing a parent to young children while on treatmentClinical trialsAlternative therapiesWorking while being a caregiver/receiving treatment Is there anything else you would like us to know: Keep me informed: Sign up for the LCC Newsletter and email updates Community Events Event Photo Galleries Fundraising #HopeUNITES LCAM Ottawa CIRCLE Peer-To-Peer Share Your Story Studentships Support Materials The Grove Volunteer Current News Achievements of Hope Lung Cancer Canada's Calendar of Hope is here! Celebrate The Achievement of Hope with 12 Faces of Hope and 12 months of practical tips towards Living with Lung Cancer Read More Standardizing biomarker testing for Canadian patients with advanced lung cancer Read LCC's abstract in Current Oncology - Standardizing biomarker testing for Canadian patients with advanced lung cancer Read More Questions To Ask Clinical Trials Share Your Story Community Activities Donate Now Peer to Peer Network
Home / Get Involved / Peer-To-Peer Peer-To-Peer Peer-to-Peer Navigators are lung cancer survivors or supporters (family members and caregivers) who have walked the lung cancer path. They know how difficult it can be dealing with lung cancer. Peer-to-Peer Navigators are volunteers who can mentor; offer encouragement, advice, experience, and hope to those newly diagnosed or anyone needing additional support through a one-on-one personal connection. Peer-to-Peer Navigators can be a vital link for a patient by being an empathetic supporter and navigator through the logistics and emotions of living with lung cancer. If you have been affected by lung cancer and would like to be matched with a Peer-to-Peer Navigator, or if you are a patient, survivor or supporter who would like to serve as a Peer-to-Peer Navigator, please fill out the form below or contact us at info@lungcancercanada.ca All information provided is kept confidential and is never shared with anyone except your support partner. This program is a free service from Lung Cancer Canada. Peer to Peer Support Request Form First Name: Last Name: Age: Gender: MaleFemale Address: Address 2: City: Province/State: Postal Code: Country: (select country) Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovinia Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (Dem. Republic) Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey and Alderney Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Island of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (Democratic Republic of) Korea (Republic of) Kosovo Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua-New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Re union Republic of Dominica Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Minor Outlying Islands Uruguay USA Uzbekistan Vanuatu Vatican (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Phone Number: Email: I am a: PatientCaregiverOther If other, please specify: I am seeking: to provide peer to peer support to othersto receive peer to peer support from a mentor Seeking support for: General SupportClinical TrialsTreatment InformationOther Check all that apply If other, please specify: Availability: PhoneEmailBoth Languages spoken: EnglishFrenchMandarinGermanItalian Others: Please list any other languages Diagnosis Date: Date and timeCalendar Age at Diagnosis: Type of Lung Cancer: Stage at Diagnosis: Current Stage: Gene Mutations: EGFRALKPDL 1 ExpressionOther If other, please specify: Previous Treatment: SurgeryChemotherapyRadiationTargeted TherapyImmunotherapyNone Please List: If checked, please list names of all previous chemo, targeted and immunotherapy drugs. Current Treatment: SurgeryChemotherapyRadiationTargeted TherapyImmunotherapyNone Please List: If checked, please list names of all previous chemo, targeted and immunotherapy drugs. Experience with: Obtaining a second opinionManaging financial implications of cancerBeing a parent to young children while on treatmentClinical trialsAlternative therapiesWorking while being a caregiver/receiving treatment Is there anything else you would like us to know: Keep me informed: Sign up for the LCC Newsletter and email updates Community Events Event Photo Galleries Fundraising #HopeUNITES LCAM Ottawa CIRCLE Peer-To-Peer Share Your Story Studentships Support Materials The Grove Volunteer Current News Achievements of Hope Lung Cancer Canada's Calendar of Hope is here! Celebrate The Achievement of Hope with 12 Faces of Hope and 12 months of practical tips towards Living with Lung Cancer Read More Standardizing biomarker testing for Canadian patients with advanced lung cancer Read LCC's abstract in Current Oncology - Standardizing biomarker testing for Canadian patients with advanced lung cancer Read More Questions To Ask Clinical Trials Share Your Story Community Activities Donate Now Peer to Peer Network