During the COVID-19 pandemic, pediatric oncology patients, caregivers, and providers were required to adapt to changes in healthcare delivery to minimize the risk of COVID-19 exposure. This study evaluated the impact of the pandemic on oncologic care and patient and caregiver distress by surveying patients actively followed for cancer treatment or on surveillance. Adherence to therapy and access to the oncology team was largely maintained with increased virtual visits. Due to concern for exposure and disruptions to work, social stressor screening and support are warranted. Continuing access to up-to-date information about COVID-19 is critical as the pandemic continues to evolve.