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Enquiry Form

Please note that all fields are required.

Name
Email
Phone
Your message To help us assist you better, please note the nature of your enquiry, including a brief description of your medical condition.
Attachment
Information collected is for statistical purposes only, as required by our Governmental funding agencies. Personal Information is not retained, sold or used for any other purposes.
Age
Gender
Postcode
Are you from a Non-English speaking background?
Are you an Aboriginal or Torres Strait Islander?
Please enter the two words displayed below into the box provided.

ILCTas is jointly funded by the:

46 Canning Street, Launceston, Tasmania 7250 Australia
T: 1300 885 886 (local call cost from anywhere in Tasmania). Contact us