I have at least two years of sobriety, and am willing to discuss my recovery without compromising the anonymity tradition that is part of most twelve-step programs.
Please enter your name (LAST NAME, FIRST NAME):
Street Address:
City:
State:
Zip Code:
Daytime Phone Number (Include area code):
Fax Number (Include area code):
Your email address:
Recovery Profile
Sex:
Date of Birth:
Ethnic Background:
Profession:
Single
Married
Domestic Partnership
Divorced
Children
What month and year did you begin your recovery?
What drugs did you use?
Please describe briefly how your recovery began:
National Council on Alcoholism and Drug Dependence, Inc.
244 East 58th Street, 4th Floor, New York, NY 10022
phone: 212/269-7797 fax: 212/269-7510
email: national@ncadd.org http://www.ncadd.org HOPE LINE: 800/NCA-CALL (24-hour Affiliate referral)