Request for support form
PalAssist provides palliative care information and compassionate support to those dealing with a life limiting illness and those who care for them.
We aim to work with health professionals in providing palliative care information and support to their clients.
When you submit a request, we will make two attempts to contact your client within 5 business days, after such time, if unsuccessful, a PalAssist team member will leave a message (if able) and encourage the client to contact us.
Please complete the form below and a member of the PalAssist team will respond to your request