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National Melanoma Support Line:
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Support Group Registration
Please complete the form below and we will be in touch with you shortly. If there is no group available in your local area you are welcome to attend any virtual online option.
Please can you share your melanoma experience in a few lines?
(Required)
Type of Melanoma
cutaneous (skin)
mucosal
uveal (eye)
acral
I am a
(Required)
Patient
Carer
Family member or friend of a patient
Name
(Required)
First
Last
Location
(Required)
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Email
(Required)
Phone number
Gender
(Required)
Male
Female
Non-binary
Agender
My gender is not listed
Prefer not to answer
Age
(Required)
Under 18
18-24
25-34
35-44
45-54
55-64
65 or Above
Prefer Not to Answer
Are you of Aboriginal or Torres Strait Islander decent?
(Required)
Yes
No
Prefer not to answer
Do you require an interpreter?
Yes
No
How did you find out about us?
(Required)
Melanoma Nurse
Other health/medical professional
Cancer Council
Family/friend
Online Search
Booklet/pamphlet/poster
Other
Which Support Group are you interested in attending?
(Required)
National Melanoma Meet Up (Online)
ACT - Canberra (Hybrid)
NSW - Hunter
NSW - Sydney
QLD - Brisbane
QLD - Gold Coast
QLD - Sunshine Coast
QLD - Toowoomba
QLD - Townsville
SA - Adelaide
TAS - Tasmania (Hybrid)
WA - Perth
Mucosal Melanoma (Online)
Metastatic Melanoma Telephone Support Group
Regional & Remote (Online)
Would you like to receive a support phone call from our specialist melanoma telehealth nurse and learn about our other support services?
(Required)
Yes
No
By registering my interest in attending an MPA support group, I consent to my details being forwarded to the relevant trained volunteer support group leader and acknowledge they will contact me on the details provided.
(Required)
I agree
About Melanoma
Patient Resources
Support
Get Involved
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About Us
Get Support: 1300 884 450
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