Would you like to refer someone to our service?

Please complete our referral form below.

Our dedicated team is here to provide the guidance, resources, and support for every person you refer.

Refer Someone Today

Please Remember

Our free programmes are available to:

Local Residents

Aged 12 and over

If you are eligible, please sign-up online or contact us via phone or email.

This service is for those wanting to quit cigarettes and other tobacco products. At this time we do not offer support for those looking to quit vapes, but please check regularly as this may change in the future.

Enquiries

Please do not use this form to refer or share personal information (such as medical records). If you need to discuss more sensitive information please contact us on 0121 740 1212