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All of Our Programs Are Currently Virtual Due to COVID-19.

Hope Connections for Cancer Support
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Hope Connections for Cancer Support
  • About
    • Experience
    • FAQ
    • Our History
    • Resources
      • Financial Resources
    • Stories
    • Hope Staff
    • Board of Directors
      • Ambassadors
    • Medical Board
  • Events
    • Fundraising Events
      • Celebration of Hope Gala
      • Drive Out Cancer Annual Golf Tournament
    • Special Activities
    • Programs Calendar
  • Programs
    • Support Groups
    • Education Programs
      • Education Programs Video Library
    • Mind Body Classes
    • Special Activities
  • Get Involved
    • Donate
    • Volunteer
    • Partners and Sponsors
    • Annual Survey
    • Team HOPE
  • Contact
    • General Questions
    • First Time Visitors Form
    • Volunteer Interest Form
    • Weekly Newsletter
    • Printable Program Calendar
  • Medical Professionals
  • Donate

First Time Visitors Form

Home / Contact / First Time Visitors Form

First Time Visitors Form

  • Your data is kept confidential at Hope Connections. Your information will never be sold or shared with a third party.
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  • Personal & Contact Information

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    Please complete the following for yourself or for the person you are here to support.
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  • Emergency Contact Information

  • Additional Information

    Please note: Attendance at an orientation is required before attending Support Groups and Mind/Body classes. Unless otherwise noted, all of our programming are for those age 18 and over. Comfortable clothing and physician approval recommended for all exercise Mind/Body Classes.
  • Please write the name of the person who referred you, or n/a if not applicable.
  • Hope Connections reserves the right to refuse to provide services to participants and to allow participants to engage in Hope Connections programs who violate or threaten to violate Hope Connections’ policies, are threatening or disruptive to staff or other participants or who appear to present a potential danger to the participant, staff or other participants.
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Become part of our community, whether or not you have cancer.  Learn how you can help Hope Connections ensure that those with cancer get the support, caring, and compassion they need.

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Bethesda Facility
10100 Laureate Way
Bethesda, MD 20814
Phone: (301) 634-7500

Directions >

info@hopeconnectionsforcancer.org

Prince George's County Facility
8201 Corporate Drive, Ste 605
Landover, MD 20785
Phone: (301) 634-7500

Directions >

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