ARC Family Support Group Interest Form

Having someone you care about who uses substances can create many problems for families and carers. The stigma and shame associated with substance use often means families and carers suffer in silence, creating isolation, despair and frustration.

We have only 20 Spaces available on our 6 week group starting Wednesday 15th September.

** Only one member per household per 6 week group **

During the 6 weeks you will gain a deeper understanding of addiction, how to put into place realistic and enforceable boundaries, and how to look after yourself and your loved one now and in the future.

**** The course cost is £30. ****

Groups will be held on Wednesday evenings from 8pm - 9pm.

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* 1. Personal Details

Name

Address

Address 2

City/Town

Post Code

Email Address

Phone Number

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* 2. Date of Birth:

(Required)

Date

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* 3. What is your gender?

Female

Male

Other (please specify)

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* 4. Have you a family member / friend currently on the ARC Programme?

Yes

No

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* 5. Problem Area your loved one is struggling with?

Alcohol

Drugs

Both

Other (please specify)

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* 6. I am aware that ARC Fitness is a Not-For-Profit Sober Active Community.

Yes

No

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* 7. Are you happy to be contacted further about attending the support group.

Yes

No

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* 8. Are you happy to be added to our ARC Fitness email list?

Yes

No