Score: 6-8

Based on your answers, you may be experiencing major problems relating to your drug use. These problems are likely to be affecting your physical and mental health, relationships, money and housing as well as possibly damaging your future health. We encourage you to take that next step and get in touch with us so we can support you to make positive changes for a healthy, safe and happy life.

Our Advice

Please get in touch – whether through our online or telephone services, or coming in to see us. We will be able to give specific advice and support in a way that is right for you.

We just need a little bit of information to get things moving – Get some help and advice – refer today.

If you would prefer to see your GP instead, make an appointment with them and let them know about your results (GPs will know it as a drug screening tool called DAST-10).
Other things to access right now: Take a look at our drug leaflet to ensure safe use.

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: 6-8

Our Advice

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