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Share Your Story

Share your story with the Dempsey Center.

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Client Registration Form – Maine (with On-Demand

...2 1 COMMON CONCERNS Below is a list of common concerns experienced by patients and family members. Please check the items you are presently experiencing. Emotional Concerns Please select all...

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Informed Consent – Oncology Counseling

...clients are faced with during a cancer impact to support adjustment and coping across the continuum, from diagnosis through survivorship or bereavement, and to help enhance quality of life. Common...

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Space to Breathe Parent Waiver

...GUARANTEE BEING MADE TO ME AND I INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY RELEASEES TO THE GREATEST EXTENT ALLOWED BY LAW, AND TO...

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Medical History Form

...cancer treatment, and general wellness. Specific results are not guaranteed. If I experience any pain or discomfort during a session, I will immediately inform the practitioner so that the treatment...

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Registration Forms

...clients interested in accessing acupuncture services. Complete Form Informed Consent – Acupuncture For clients accessing acupuncture services. Complete Form Medical History Form For clients accessing Dempsey Center services. Complete Form...

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General Volunteer Application

...training and volunteer commitment. Every effort will be made to match you with the volunteer opportunity that best meets your needs and the needs of the Center. Volunteer Position Applied...

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Out-of-State On-Demand DCO

Complete your Dempsey Center Orientation Find comfort through compassion, connection, and choice. Become a Dempsey Center client today by completing the Orientation video and other documents below. Here, you will...

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Informed Consent – Youth + Family

...have the right to know about the confidential communications we have with your child. Confidential communications may be shared with you at your request, unless a licensed clinician determines, based...

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Kids, Teens, and Family Resources

Youth + Family Resources To help with questions you may have about communicating about cancer with the young people in your life, the Youth and Family Team has compiled suggestions...

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Clayton’s House Guest Application

Clayton’s House Guest Application and Waiver Form For completion by Guest Submission of this completed Form is a pre-requisite to a Guest’s stay at Clayton’s House. Identification of Guest Name:(Required)...

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Consent to Telehealth Services

Client Consent to Telehealth Services and Acknowledgement of Receipt of Telehealth Information – Nutrition The Dempsey Center for Quality Cancer Care is committed to improving the health and wellbeing of...

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Telehealth Consent – Counseling

Telehealth Services Consent and Acknowledgement of Receipt of Telehealth Information – Counseling Name(Required) First Last Phone(Required) Email The Dempsey Center for Quality Cancer Care is committed to improving the health...

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Meet the Team

...Michaud (he/him) Board Treasurer, Finance Committee Chair Director of Research, H.M. Payson Cary Olson-Cartwright (she/her) Assistant Vice President of Corporate Social Responsibility, Unum Wendy Reid (she/her) Chief Operating Officer, The...

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Resources to Help

...a national virtual care and navigation company, announced today that the company is offering free virtual mental health support service to all Maine residents in response to the ongoing tragedy...

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Counseling Support Resources

...Name + LinkDescription CancerCare Provides free emotional and practical support for people with cancer, caregivers, loved ones and the bereaved. My Lifeline From Cancer Support Community this was created to...

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