Peer Buddy service referral form

Please use the form below to tell us about the issues you would like support with. Both patients and family members/carers can access support through this form. Please note that the person who will receive support should complete this form directly. If you need help completing this form, please call the Myeloma UK Infoline on 0800 980 3332 (UK) or 1800 937 773 (Ireland) to go through it.

Please note that the Peer Buddy service is not a counselling service. All information in this form will be processed in line with relevant GDPR protocols.