Welcome

Start your recovery journey

Estimated time: 3 minutes

Complete our short quiz to check if our home-based detox and recovery program is right for you.

Your answers will help our clinical team understand your needs and create a personalised treatment plan, designed to achieve your goals.

By completing our suitability quiz, you agree to our Privacy Policy.

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Have you ever had an alcohol withdrawal seizure?

An alcohol withdrawal seizure occurs after you've suddenly stopped drinking. Typically you would lose consciousness and your body moves uncontrollably.

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Yes

👎

🤷

Unsure

How would you describe your current thinking about your relationship with alcohol?

I've made changes and want support to maintain them

I'm actively making changes and looking for support

I'm planning to make a change soon

I'm thinking about making changes but not sure when or how

I'm not thinking about making changes right now

What is your postcode?

We are partnered with Government funded Primary Health Networks across Australia and may be able to provide a funded placement based on your location.

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Do you have private health insurance?

We are partnered with 30 Australian private health insurers and may be able to provide a funded placement based on your membership.

👍

Yes

👎

Your membership details:

Who is your health insurance provider?

What level of cover do you have?

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We just need a few final details to personalise your results and guide you through the next steps.

First name

Please enter your first name

Last name

Please enter your last name

Email address

Please enter a valid email address

We’ll only use this to share your results and any helpful resources - no spam, ever.

Start your recovery journey

How many days per week do you drink?

How much do you drink per session?

Have you ever had an alcohol withdrawal seizure?

Do you have concerns with any other drug or substance?

What substances do you use and how frequently do you use them?

How would you describe your current thinking about your relationship with alcohol?

What is your postcode?

Do you have private health insurance?

Your membership details:

How did you hear about Clean Slate Clinic?

You're almost done

Thanks, @first_name!

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