ARC Fitness Addiction Recovery Programme 

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* 1. Personal Details

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* 2. Date of Birth:

Date

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* 3. What is your gender?

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* 4. Are you inquiring about the programme for?

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* 5. Are you currently engaged with Addiction Services in the community?

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* 6. Are you currently involved with Probation Services PBNI/ PSNI / Youth Justice?

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* 7. Problem Area

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* 8. Length of Time in Recovery (at time of application)

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* 9. Please provide a brief description of Substance use

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* 10. Current level of fitness

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* 11. Are there any physical health conditions that would prevent you from engaging in physical activity?

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* 12. I am aware the ARC Fitness Programme promotes ABSTINENCE from substances from all its participants.

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* 13. Are you happy to be added to our ARC Fitness email list?

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