STEP 2 - CAN YOU TELL US A LITTLE MORE?

WE REALLY WANT TO TAILOR OUR SUPPORT FOR YOUR INDIVIDUAL NEEDS. YOU CAN HELP US BY TELLING US MORE ABOUT THE FOLLOWING:

    1

    What drugs do you use? Please list here

    2

    How often do you use drugs?

    Times or less

    PER DAY

    3

    How many times a week are you taking drugs?

    Times or less

    PER WEEK

    4

    How much do you spend on drugs in a week?

    £

    £
    OR LESS

    (£)PER WEEK

    5

    How has taking drugs negatively impacted your life?

    6

    What's the impact of your drug taking on family and friends?

    7

    Have you been diagnosed with depression or any other mental health condition?

    8

    Have you tried stopping before? If yes please give details here

    9

    Why do you want to stop now?

    10

    How much support do you think you need to stop?

    11

    What does your life look like free from the addiction?

    12

    About You


    13

    Your Contact Details



     

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