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Providing healthy clean homes for Cancer patients and their families in Canterbury
Apply for Our Free Service below.
First name
*
Last name
*
Contact Email
*
Contact Number
*
Application Submitted by and relationship
Oncologists name, email and location
*
Diagnosis and Date of Diagnosis. You will need to send confirmation of your diagnosis to qualify for our Free service.
Current treatment plan
Do you have any pets
How many people live in your house
1-2
3-4
5 +
Have you read our terms and conditions?
*
Submit Form
*By submitting your application you are agreeing that you have read, understood and comply to our terms and conditions which can be found here.
Terms and Conditions
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