Service Agreement

Addictions UK
PO Box 182,
Chester-le-Street,
DH2 1ZZ

0300 330 30 40

You may download and print out a copy of this document in .pdf format.

Your contact details

First Name

Last Name

Telephone

Mobile

Your Email

Subject

Your Message

Anything pre-entered above may have been stored as a cookie on your computer to save you re-typing it. We do not use cookies to store any medical or other personal information.

I confirm that I have read and agree to the Addictions UK Service Agreement.

EITHER

I consent to my Medical Practitioners being informed of any treatment organized by Addictions UK.

OR

I do not wish my Medical Practitioners to be informed of any treatment organized by Addictions UK and I indemnify Addictions UK and their Medical Officers against any consequences of this decision.