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

    1

    How many addictions do you have and what are they?

    2

    What is the biggest addiction?

    3

    How much are you spending weekly on your addictions?

    £

    PER WEEK

    4

    Have you tried stopping any of them before?

    YesNo

    If yes, which ones and what did you do?

    5

    How long have you been addicted?

    6

    How much negative impact are these addictions having on other areas of your life?

    7

    How much negative impact are these addictions having on your relationships?

    8

    Have you been diagnosed with a mental health condition?

    9

    Why have you now decided to get help?

    10

    What do you think your life would feel/look like without the addictions?

    11

    About You


    12

    Your Contact Details



     

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