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. Outside of our fully funded places on the programme, we also have the option of privately paid for services. If you are in the position to avail of this service please select your answer below. 

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

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

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