The Base - Kirklees

This form is for drug and alcohol support. If you are looking for smoking and vaping support, you'll find information on our smoking and vaping page.

Make a referral

Please complete this referral form for children and young people under the age of 18 who are impacted by a family member's drug or alcohol use. For children 12 years and under we require consent from a parent/guardian with parental responsibility.