Making an Assessment Appointment

Before your first appointment at the Clinic, you will need to have completed a Personal History Form. This can be downloaded using the link below.
The form is in Portable Document Format (PDF). Adobe Reader (freely available from www.adobe.com) must be installed on your computer to read it.
Then, print the blank form, enter the details manually and post it to:-



Click to download form in PDF

If you have any difficulty with obtaining this form please contact the Stapleford Centre on 020 7823 6840 (or by Email) and a copy will be sent to you.

Other Requirements

You will also need to send:
1 A Deposit of £150,
2 Documented Proof of Ability to Pay for Treatment*,
3 Four Colour Passport-type Photographs of yourself*.

* for Methadone Maintenance Patients only,


A checklist of the necessary items (in PDF) can be downloaded by clicking here.

Text only / Print Version