Beta Testers Wanted

24/7 Help Yourself is a brand new concept in alcohol treatment. It is a self-help website that puts you in charge of your goals and drinking. The website, based on the latest research, has been created to give you the tools necessary to change your life.

The site will be launched at the end of April but currently we are looking for people to Beta Test the site. This means that you would use the site and feedback on the things that work or don't work for you. If you are someone who has a drink problem and is willing to Beta Test the site then fill in the form below.

Thank you for your assistance.

Beta Testers Wanted

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

E-mail Address*
E-mail Address*

City*
City*

Country*
Country*

What age are you?*
What age are you?*

Do you have a problem with your drinking?*
Do you have a problem with your drinking?*

	A Yes
	B No

How long have you had a drinking problem?*
How long have you had a drinking problem?*

Have you ever had treatment for your problem?*
Have you ever had treatment for your problem?*

	A Yes
	B No

Have you attended self-help groups, eg AA?*
Have you attended self-help groups, eg AA?*

	A Yes
	B No

Why do you want to Beta Test this site?*
Why do you want to Beta Test this site?*

Are you willing to provide detailed feedback about the site?

	A Yes
	B No

Please enter the word that you see below.

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