Alcohol & Other Drugs Referral Form

This service is only available within South Australia. Check our services page for specific locations. Or contact Head to Health directly on 1800 595 212 or visit website for alternative services in their area.

Referrer Details

GP Details

Reasons for referral

Click or drag files to this area to upload. You can upload up to 5 files.

Substance(s) of Concern

Other agencies or supports involved