Need Help?

If you need help overcoming addictions, we would love to chat with you. Please complete the form below. Please be aware that due to a large number of enquiries we will only contact you when we have a vacancy.

You are also welcome to contact us by telephone to discuss your circumstances.

The information you provide is treated as private and confidential in accordance with our Privacy Policy.

Last Name (required)

First Name (required)

Telephone (required)

Your Email (required)

Age (required)

Town / Suburb

What health service providers are you currently linked with? (eg. alcohol and other drug agencies, mental health workers, counsellors)

Please provide a brief description of your substance use?

Briefly describe any prior involvement in detox and/or rehabilitation programs?

Other Comments

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