Referrals

If you're a young person, family or professional, below you will find all our referral forms.

We are currently experiencing some technical difficulties with our online referral forms.  If you are unable to use the links please try the form below and email the completed form to info@earlybreak.co.uk

Alternatively, if you are having further issues please call us on 0161 723 3880 or email info@earlybreak.co.uk and speak to a member of our Support Services Team.

Apologies for the inconvenience.

Young People’s Drug & Alcohol Referral Form