You Can Stay
Repeat Accommodation Booking Form
(please use this form if a patient has previously been referred to the program, has checked out, and is returning for a new stay)
REFERRER DETAILS
YOUTH CANCER PATIENT DETAILS
Treating hospital details
Supporting Information
- Next phase of treatment / complexity of treatment / financial impact of treatment on patient and family
Details for Quest
Some properties provide complimentary parking. If parking is essential and the patient/family are unable to cover their own parking costs, please indicate this and Sony Foundation will also cover the cost. Please note that if there is a need for long stay accommodation, we may request the patient/family stay at a Quest location with free parking.
Thank you for completing the referral form.
Please make sure to click the SUBMIT button below.
If your form has been successfully submitted online, you will receive a confirmation email.
If you do not receive a confirmation email, please try again or email the patient details to info@sonyfoundation.org.au
Sony Foundation will advise if the patient meets eligibility criteria.
Quest will then contact the primary contact to coordinate the accommodation in the next 24 - 48 hrs.
If you have any questions, please contact; info@sonyfoundation.org.au
