Free & confidential

Request your free assessment

Thank you for joining our webinar on Understanding Addiction. If you're concerned about yourself or someone you care about, request a free, confidential assessment below. Your information is seen only by our clinical team and is never shared without your consent. This is not a diagnosis and not an emergency service.

1. About you

First name, or a name we can call you

Preferred contact *

Contact number

Best time to reach you (optional)

Age range (optional)

Location (optional)

2. Who is this for?

I'm asking for *

3. Area of concern (choose any)

4. Quick checkAnswer for the person concerned — this helps us prepare, it is not a diagnosis.

Over the past 2 weeks, how often have you felt little interest or pleasure in doing things?

Over the past 2 weeks, how often have you felt down, depressed or hopeless?

Over the past 2 weeks, how often have you felt nervous, anxious or on edge?

Over the past 2 weeks, how often have you been unable to stop or control worrying?

In the past 12 months, has substance use or a behaviour caused problems at home, work or with health?

Have you tried to cut down or stop and found it hard?

Anything else you'd like us to know? (optional)

5. ConsentI consent to Eden Renewal Centre collecting and using this information to contact me about a free assessment, under the Personal Data Protection Act 2010.I understand this is not an emergency service.

If you or someone else is in immediate danger, call 999. For emotional support, contact Talian HEAL 15555 or Befrienders KL at 03-7627 2929.

Your details are kept strictly confidential and handled in line with the PDPA Act 2010 (Malaysia) and, where applicable, the GDPR.