The Society of St James

Help us help you make your life better

If you are over 18, concerned about your drug and/or alcohol use and a resident of Portsmouth, please help us to help you make your life better by filling out this form

Professional Referrer Details

Please work with your client to complete the questions on the following pages

Your Addess

How can we best meet those needs?

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Pressing submit on this form means you are giving your permission for The Society of St James to store the information you have provided and contact you in-line with Data Protection legislation ( We will contact you on the phone number or email provided so we can determine how we can best support you in our service.

Professional Referral