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Friday Monday application form

To apply for the Friday/Monday online one-to-one counselling, online support group or follow-up online monthly drop-in 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, online one-to-one counselling or follow-up online monthly drop-in group.. 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.

About you

Drug use

What substances are you using?

Availability

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.

Provided by Terrence Higgins Trust in partnership with the LGBT drug and alcohol service Antidote at London Friend.