Get help now
To apply for the Friday/Monday online one-to-one counselling or online support group you will need to fill out the form below which asks for some very basic information about you, and a little about your relationship with sex, drugs and alcohol.
You don’t have to use your full or your real name. You will however need to give us a valid email address and let us know the best telephone number we can contact you on.
Once you have filled out the form, you will be referred to either the online support group or online one-to-one counselling. We will be in touch with you by phone or email within seven days. Please note that due to demand the waiting time for the online support group is currently about two weeks and the waiting time for online one-to-one counselling is about six weeks.
These services are provided by Terrence Higgins Trust in partnership with the LGBT drug and alcohol service Antidote at London Friend.
The service is currently only available to people living in England.
All personal information gathered on this form is confidential, meaning it is not shared with organisations beyond Terrence Higgins Trust and London Friend. Anonymised data will be used for the purpose of evaluating the project. Any further details provided by you will be held confidentially.
First name (required)
First part of your postcode (required)
Borough, Town or City
Daytime or mobile telephone (required)
Preferred contact method:
Is it ok to leave a phone message?
What is your gender? (required)
---MaleFemaleOther gender identity
If other gender identity, please say here
Was this the gender that was assigned to you at birth?
How would you best describe your sexuality? (required)
---GayBisexualHeterosexualLesbianI'd rather not sayOther
If other sexuality please state here
Date of birth (required)
Do you consider yourself to have a disability? (required)
Your ethnic group (required)
---White BritishWhite: EnglishWhite: Northern IrishWhite: ScottishWhite: WelshWhite: IrishAny other White backgroundMixed, White and Black CaribbeanMixed, White and Black AfricanMixed: White and AsianAny other mixed backgroundAsian: IndianAsian: PakistaniAsian: BangladeshiAny other Asian backgroundChineseBlack or Black British: AfricanBlack or Black British: CaribbeanAny other black backgroundAny other ethnic background
---No religionChristianBuddhistHinduJewishMuslimSikhOther religion
If other religion please state here
Are you HIV positive? (required)
---YesNoUntestedRather not say
How did you find out about this service?
---FacebookFriday/Monday websiteLondon FriendSexual health clinicTerrence Higgins Trust websiteTHT DirectOther
If other method please say here
What substances are you using?
AlcoholCannabisCocaineCrystal methG (GHB/GBL)KetamineMDMA (Ecstasy)Mephedrone
If you use other substances, please list them
How often do you use drugs?
When using drugs or alcohol how long on average would you take them before stopping (in hours or days)?
Do you inject drugs?
If yes how many times each month do you inject them?
What context are you using in? For example clubs, saunas, sex parties
What changes do you want to make? For example stopping, reducing, being safe
Which service would you like to apply for? (required)
---Online one-to-one counsellingOnline support group
We will not be able to offer services every day of the week but please let us know your general availability as this will help us determine the optimum days to run these services. It is likely services will run a few set days each week.
Monday 10am-5pmMonday 5pm-9pmTuesday 10am-5pmTuesday 5pm-9pmWednesday 10am-5pmWednesday 5pm-9pmThursday 10am-5pmThursday 5pm-9pmFriday 10am-5pmFriday 5pm-9pmSaturday 10am-5pmSunday 5pm-9pmSunday 10am-5pm
I confirm I have read and agree with the terms and conditions.
I confirm I live in England
Provided by Terrence Higgins Trust in partnership with the LGBT drug and alcohol service Antidote at London Friend.