If you want to talk to someone about cutting down on your drinking, just complete our self referral form below and get some confidential specialist support.  

 

Referral form

Please note - we can only provide this confidential specialist support to people living in the city of Derby (the area served by Derby City Council).

If you live outside Derby, you are still welcome to look around the Drinkwise Derby site and read our advice, use the tools and tips for cutting down and take our self-assessment quiz. For further help outside Derby, visit these sites:

Derbyshire: Derbyshire Recovery Partnership

Nottinghamshire: Change Grow Live

Staffordshire: Human Kind

Once we have received your referral form, we will aim to contact you by phone or email within 48 hours to discuss the support we can offer you.

 

Self-Referral Form

Required
Required
Date of Birth Required
Address Required
Have you previously served in the UK armed forces (including TA)?
Required