Darlington online referral form

Complete this form to refer yourself or someone else to WithYou's drug and alcohol support service in Darlington.

Online referral form

Darlington Referral form

Online referral form

STRIDE - Darlington

STRIDE (Supporting Treatment & Recovery in Darlington through Empowerment) is Darlington’s free and confidential drug and alcohol partnership, offering help with support, treatment and recovery. You can get help whether you want advice, to cut down or to stop using drugs or alcohol altogether. The team works with you to understand your goals and support you in a way that feels right for you.

Find out more information on services available for support through either the STRIDE engagement team, We Are With You free and confidential services or recovery support at Recovery Connections.

To view our full privacy policy please follow the link below

WithYou Privacy Policy 

 

Who are you referring?
Personal details of the person you are referring

Personal details of the person you are referring

What are their preferred gender pronouns?
Contact details of the person you are referring

Contact details of the person you are referring

Does the person you are referring have a fixed address?
How can we support the person you are referring?

How can we support the person you are referring?

Please confirm this person is happy to be contacted by the WithYou team? How would this person prefer to be contacted?
If we are unable to contact this person by preferred method, please confirm if you are happy for us to contact by post / phone / text?
Your details

Your details

Do you have the permission of the person you are referring to share their personal information with us?