Request a publication

Before completing this form, please note that:

  • We are only able to mail to Canadian addresses.
  • We cannot send information to a third party - we can only send information to the person who is requesting the information.
  • You may order up to 5 different titles on this form.
  • For bulk orders (more than 5 copies of one item or a total of more than 10 items) please contact your local Canadian Cancer Society office.
  • If you haven't found what you need, please e-mail us us or call an information specialist at 1 888 939-3333.

All items marked * are required.

1. Personal information
  First name:
  Last name:
  Address line 1:
  Address line 2:
  Postal code:
  Phone number:
  E-mail address:
2. Requested information
  First publication:
  Second publication:
  Third publication:
  Fourth publication:
  Fifth publication: