Caring Connection Program - Volunteer

Caring Connections Program

Volunteer to mentor a New Patient or Caregiver

Often, patients starting the transplant or CAR T-cell process find it very helpful to talk with someone who has been through the procedure. BMT InfoNet's Caring Connections program links with others who understand their concerns and can provide emotional support:

Patients about to go through a transplant or CAR T-cell therapy
Caregivers
Bone marrow and stem cell donors

Complete the form to become a Caring Connections volunteer. A Caring Connection Support Specialist will then call to welcome you, review the program, answer your questions, and discuss how to be a good mentor.

If you have questions, email cindy@bmtinfonet or phone us at 888-597-7674.

First Name

Last Name

Phone Number

Phone Type

Cell

Landline

Street Address

Street Address Line 2

City

State/Province

Postal Code

Country

Your Birth Month and Year

Patient Info & Relationship

Relationship to Patient

Relationship Other

Patient First Name

Patient Last Name

Diagnosis Info

Disease

Type in diagnosis to see list or select Other and complete the disease description.

Disease Description -

If your disease was not listed above enter it here.

Disease Subtype

What type of therapy did you/the patient have?

Transplant - bone marrow, stem cell or cord blood

CAR T-Cell Therapy

Unsure

Other…

Transplant Info

Number of Transplants

Date of Most Recent

Patient Age at time of transplant

Your Age at time of the transplant

Transplant Type

Donor type

Type of cells used

Transplant Center Name

Notes about Previous Transplants (PRT)