Stop Cocaine Pre-Booking

Pre-Book Now

End Point
The goal of any treatment process is to help the individual get to the 'end point' where they feel as though they don't want any cocaine and can stop using it, which we can help achieve much quicker than any other treatment method.

Please indicate when you would like to stop using cocaine and we will then contact you to discuss the number of treatment sessions required usually just one to five sessions for most people.

Each appointment is 2 hours per day.

Please complete the form opposite and we will contact you shortly to confirm the appointment.

Appointments available Monday to Saturday. *Closed

Thank you.

Name *

Telephone / Mobile no *

E-Mail Address *

How many grams do you use per week?

Start Treatment Date

Month

Time

Main reason for stopping?

Preferred treatment location?

How did you hear about us?

Do you think NHS the should commission better stop cocaine use services?

Comments*