NHAA DISTRICT 12

Request an AA Contact

Please indicate male or female *

Male

Female

First Name *

Town *

Email Address

Phone *

How would you characterize your current condition? (Please check all that are true for you) *

I’d like to ask questions – I feel OK

I’d like to talk now – I don’t feel good

I’m in or just got out of treatment

I’m in or just got released from incarceration

I don’t have transportation

I want to get to A.A. meetings

Any special needs?

Date

Best regards, Thank you for your request. Your Temporary AA contact will connect with you as soon as possible. District 12 Treatment Chairman District 12 A.A. NH A.A. HOTLINE 1-800-593-3330

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