Responders Take Action Your name or Responder ID*This field is hidden when viewing the formDateGender of the person you spoke with Male Female Other Age of the person you worked with (can be estimated) Under 18 18 - 24 25 - 34 35 - 49 50 - 64 65 and over Substance/s UsedAction Taken Harm Reduction Advice Self-Help Signposted On Referred On Something Else Other notes (optional) *Do not put any identifiable information on here about the person you spoke with*
