Drug Alcohol News: Christchurch City Mission calls for help

Your Name:*

Your Email:*

Your Phone Number:*

Person who needs help is...*
SelfHusbandWifeSonDaughterFatherMotherLoved OneFriendMy PatientOther

State the Addict is in:*
ALAKASAZARCACOCTDEDCFMFLGAGUHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPWPAPRRISCSDTNTXUTVTVIVAWAWVWIWY

Zip Code:*

What substance is being abused?

Is medical insurance available for treatment?
YesNoNot Sure

How much out of pocket money is available for addiction treatment?
NoneNot Sure$1,000-$5,000$5,000-$15,000$15,000-$25,000$25,000 +

Please enter in the numbers below (spam prevention):