Psycho-oncology Network EOI 1. About you By filling out this survey you are indicating an interest in joining a Mental Health Professionals Network group that has a focus on psycho-oncology. Question Title * 1. Name: Question Title * 2. What is your profession? General Practitioner Psychologist Social Worker Psychiatrist Occupational Therapist Mental Health Nurse Paediatrician Other Please specify Question Title * 3. Practice contact Details: Practice Address: Phone: Email Address: FAX Number: Question Title * 4. Please check the box next to the topics that are of interest to you. Depression and cancer. Anxiety and cancer. The normal range of psychological reactions to a diagnosis of cancer or cancer progression. Major psychiatric illness and cancer (eg schizophrenia, bipolar disorder, cognitive impairment) Drug dependence and cancer Supporting the family of the cancer patient Other (please specify) Thank you for filling out this expression of interest. If there is enough interest in establishing a psycho-oncology network then we will plan an initial meeting for early 2012 and you will receive an invitation. If you do not receive an invitation in the new year then that is an indication that the interest did not warrant the establishment of a network at this stage. Done
