Request a Speaker

Interested in requesting a speaker for your next lecture or talk? Please complete the form below, and we’ll be in touch:

REQUEST A SPEAKER

Your Information
Name*
First Last
Company/Organization
Email*
Phone*
Event Details
Preferred Speaking Topic(s)*
- About Life with Cancer - General Program & Services
- Brain Fog/Chemobrain Facts and Strategies
- Caregiving
- Children and Adolescents Impacted by Cancer
- Couples
- Depression and Anxiety Management
- Fear of Recurrence
- Fitness
- Grief and Bereavement
- Insomnia
- Late Effects
- Mind/Body Practices
- Neuropathy
- Nutrition
- Oncology Nurse Education
- Resilience and Survivorship
- Sexual Health
- Specific Cancers (Please include cancer type in Message section below)
- Stress Reduction
- Survivorship
- Survivorship Care Plans
- Understanding Clinical Trials
- Understanding Lab Values
- Other
Date of Event*
MM slash DD slash YYYY
Time of Event*

: Hours

Minutes

AM/PM
Location of Event*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Number of Attendees*
Message*

Can We Help You?

Life with Cancer Connect
A direct link to your support team

For counseling and education, programs, support groups, and resources, please contact us:

703-206-5433 (LIFE)
lifewithcancer@inova.org

Get Help

Find support through programs

Class & Group Registration

Need to talk with someone?

Get in touch with one of our team members.

Contact Us

Life with Cancer Family Center
Main Office
8411 Pennell Street
Fairfax, VA 22031
Phone: 703-206-5433 (LIFE)

Life with Cancer Connect
A direct link to your support team
703-206-5433 (LIFE)
lifewithcancer@inova.org

Inova Schar Cancer Institute
571-472-4724
Find Out More

Subscribe for Updates
Sign up to receive news and events from us in your email.

Class Registration
Upcoming Events
Donate
Privacy Policy

Website by Yoko Co.

We're still updating our event registration system, and it currently looks different than our website. By clicking okay below, you'll be taken to our event registration system to register for counseling and education, programs and support groups.

Request a Speaker