Refer a friend or relative

When you realise someone you love or care about has a problem with drugs, alcohol or gambling it can be a frightening prospect. It could be your brother, husband, partner, boyfriend, son, father, nephew, uncle, cousin or your BFF – and you have witnessed their life unravel before your very eyes.

You may, or may not have confronted them; you may, or may not know what to do; you may, or may not have your own internal head/heart conflict to deal with.

Whatever your circumstances, and whoever is the person in question, we are here as a first point of contact. We can talk through the situation with you and make you aware of what help and support is on offer – either here at Chandos, or by signposting you to other service providers. Help and support IS available – for you AND for your loved one.

Call us today on 0117 924 3071 for a free, informal and confidential conversation.

Refer someone for a place

Please complete the referral form below, giving as full a picture as possible of applicant. All information is held in the strictest of confidence and will be destroyed if we are unable to offer the applicant a place. Alternatively you may download an application form here.

Name of applicant:

Applicant's date of birth:

Name of treatment centre/Counsellor/Keyworker:

Treatment Centre/Counsellor/Keyworker's Address

Treatment Centre/Counsellor/Keyworker's Telephone:

Treatment Centre/Counsellor/Keyworker's Email_address:

Care Manager/Funder:

Care_Manager/Funder's Address

Care_Manager/Funder's Telephone:

Care_Manager/Funder's Email_address:

Has funding been confirmed for treatment at Chandos House? Has funding been confirmed for treatment at Chandos House? Yes No

Brief history of your client’s use of drugs and/or alcohol? Which drugs, in what quantity, how frequently & for how long?

How has the applicant progressed so far? What has been the focus of this treatment?

Details of past and current legal situation (if applicable) Please include forthcoming court appearances, probation or D.T.T.O.

Give details of any significant family involvement during your client’s treatment:

Is there a psychiatric history? If so, please supply a medical report.

Has the applicant presented any behavioural/attitude problems whilst with you?

Has the applicant been given any therapeutic conditions, warnings or contracts during your work together? Please give full details

Does your client have any other requirements that we should be aware of?

Please provide any other information that you feel is relevant to this referral:

3 + 4 =