Make a referral to Enable Drug and Alcohol Services in Enfield Contact us Note: Questions marked by * are mandatory *This is a mandatory field. Full name *This is a mandatory field. Email *This is a mandatory field. Contact telephone number Ok to leave a message? Please Select An Option YesNo *This is a mandatory field. Date of birth Full address including postcode Gender Please Select An Option MaleFemaleTransgender Rather not say Ethnicity Please Select An Option White BritishWhite IrishWhite OtherBlack CaribbeanBlack AfricanBlack OtherAsian BangladeshiAsian IndianAsian PakistaniAsian OtherMixed White & AsianMixed White & Black AfricanMixed White & Black CaribbeanMIxed White British & CaribbeanMixed OtherChineseAny Other How often do you have a drink containing alcohol? Please Select An Option NeverMonthly or less2-4 times a month2-3 times a week4+ times a week How many units of alcohol do you drink on a typical day when you are drinking? Please Select An Option 1-23-45-67-910+ How often have you had 6 or more units on a single occasion in the last year? Please Select An Option NeverLess than monthlyMonthlyWeeklyDaily Do you smoke? Daily or socially? Have you ever used other substances? How often? How old when you first tried them? Please share any other information about your drug and alcohol use or your mental health that you think may be useful for us to know. Please note: by clicking submit on this form you are giving your consent for us use your details to contact you.
