• Complete the following questions to express your interest in participating in a scheduled My Recovery program. We will contact you to confirm receipt and your enrolment in the program you have nominated. Please note: If you are completing this form for someone else, it is expected that person has provided you with consent.
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  • Please write down the name of the My Recovery program and start date for the program that you want to attend:
  • If there are potential barriers to your participation that you would like us to talk to you about, please let us know (e.g. transport, kids, work or other commitments). There may be practical ways we can help.