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I hereby apply for Membership of the Pertubuhan Untuk Advokasi Dan Kesedaran Kanser Kuching and declare that I hereby agree to abide by the Constitution and Bye-Laws of SCAN
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Additional Information
Information in this section is not required for membership but will help us understand you the member more.
I am a
Cancer Patient / Survivor
Caregiver of a cancer patient
tick all that applies
Cancer Patient / Survivor Information
What Cancer were you diagnosed with?
What Stage was your cancer? (at diagnosis)
You can enter I don’t remember or I don’t know.
In what year were you diagnosed with cancer?
Are you currently under treatment?
Yes
No
Are you in remission?
Yes
No
Caregiver Information
What Cancer was the person you are caring for diagnosed with?
What Stage was their cancer? (at diagnosis)
You can enter I don’t remember or I don’t know.
In what year were they diagnosed with cancer?
Are they currently under treatment?
Yes
No
Other
Are they in remission?
Yes
No
Other
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