№ files_lp_4_process_1_38936
Administrative intake form used by the Hampshire 24/7 Young People’s Drug & Alcohol Service to record personal information, substance use details, health and risk factors, and referral data for young individuals seeking or being directed to support services.
Region / County: Hampshire
Country: United Kingdom
Service Name: 24/7 Young People’s Drug & Alcohol Service
Organization: Catch22
Document Type: Referral Form
Subject: Youth Drug and Alcohol Support
Target Group: Young people with drug or alcohol use concerns
Fields Included: Personal details, family details, education or employment information, health issues, risk assessment, substance use details, consent information, referrer details
Substances Listed: Alcohol, LSD, Magic Mushrooms, Cannabis, Codeine, Tramadol, Opiates, Solvents, Ketamine, Ecstasy/MDMA, Benzodiazepines, Cocaine Powder, Heroin, Crack Cocaine, Prescription Drugs, Amphetamines, Mephedrone, NPS
Consent Requirement: Consent from the young person and awareness of parent or person with parental responsibility
Contact Method: Email submission
Submission Email: [email protected]
Contact Telephone: 0845 459 9405
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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