Score: 20-40

Possible Dependence

The way that you are drinking is likely to be affecting your physical and mental health, and even your relationships.

If you have scored at this level, we recommend that you don’t suddenly stop as this may be dangerous and could make you very unwell. Find out more on Drinkaware withdrawal symptoms.

Our Advice

We can help you make positive changes and reduce the problems drinking may be causing you. Please contact us to get specific advice and support. You can now make a referral below.

If you don’t want to see one of our workers, you can also speak to your GP who will be able to offer you support and advice.

When we receive your referral form, our service will be in touch to complete an assessment with you.

If you are from an agency, we may require further information and will send you a further area-specific form to complete.

Full name (of person needing support) (Required)

Date of birth (Required)

Email address (Required)

Telephone (Required)

Mobile

Address

Postcode

Organisation & name of person referring client (If applicable)

Organisation email address (If applicable)

If you are contacting us on behalf of someone else please tick to confirm you have their consent to contact us.
YesNoN/A

What service location would you like to refer into? (Required)

How can we contact you (Required)
EmailTelephone

How can we help? Please provide as much detail as possible. (Required)

We will respond to your enquiry as soon as we can. If you are in danger, or there is a risk to life, please call the emergency services.

Score: 20-40

Possible Dependence

Our Advice

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