Service profile Please complete the following details so NADA can provide targeted services for our members. If you are applying for an associate membership please ensure the details given are AOD specific to your service/organisation. What is the core business of your service? Check only the most relevant Counselling Withdrawal management (detoxification) Rehabilitation activities Maintenance pharmacotherapy (opioid) Maintenance pharmacotherapy (non-opioid) Consultation activities Support and case management Involuntary treatment Assessment Information and education Harm reduction and other services Check only the most relevant Health promotion Community development School-based programs Peer education Needle and syringe program Family support Living skills programs Policy Research Service delivery setting only the most relevant Community/Outpatient Inpatient Residential Home Correctional Priority population Check only the most relevant Men Injecting drug Women Homeless Young people People with comorbid mental health and AOD Aboriginal/Torres Strait Islander Culturally and linguistically diverse communities Families People connected to, or from the criminal justice system Parents with children Gay, lesbian, bisexual, transgender, intersex Other Source of funding Check all that apply State Commonwealth Other NSW Health DoH NGOTGP Client contribution Local Health District DoH SMSDGF Private/Philanthropic Family and Community Services DP&MC IAS Criminal Justice Dept of Social Services Other Primary Health Network numbers Check one only Number of staff (in terms of full time equivalent positions) 5 or fewer 6 to 30 Over 30 Other service description Optional
Service profile Please complete the following details so NADA can provide targeted services for our members. If you are applying for an associate membership please ensure the details given are AOD specific to your service/organisation. What is the core business of your service? Check only the most relevant Counselling Rehabilitation activities Maintenance pharmacotherapy (non-opioid) Support and case management Assessment Withdrawal management (detoxification) Maintenance pharmacotherapy (opioid) Consultation activities Involuntary treatment Information and education Harm reduction and other services Check only the most relevant Health promotion Peer education Living skills programs Community development Needle and syringe program Policy School-based programs Family support Research Service delivery setting only the most relevant Community/Outpatient Home Inpatient Correctional Residential Priority population Check only the most relevant Men Women Young people Aboriginal/Torres Strait Islander Families Parents with children Injecting drug Homeless People with comorbid mental health and AOD Culturally and linguistically diverse communities People connected to, or from the criminal justice system Gay, lesbian, bisexual, transgender, intersex Other Source of funding Check all that apply State Commonwealth Other NSW Health Local Health District Family and Community Services Criminal Justice DoH NGOTGP DoH SMSDGF DP&MC IAS Dept of Social Services Primary Health Network Client contribution Private/Philanthropic Other numbers Check one only Number of staff (in terms of full time equivalent positions) 5 or fewer 6 to 30 Over 30 Other service description Optional
interactive-nada-membership-form-2017b.docx