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Client Intake Packet

The Client Intake Packet needs to be filled out by every EAP client.   Prior to your scheduled appointment, please complete the Client Intake Packet.  The Statement of Understanding and the Notice of Privacy Practices needs to be read and signed.  Please bring your completed Client Intake Packet to your scheduled appointment or fax it prior to meeting with your Employee Assistance Professional.  To protect your confidentiality, please do not e-mail your information to the EAP.   If you have any questions please contact your nearest Regional EAP office for information or to schedule an appointment.


Intake Form-Client

Statement of Understanding

Notice Of Privacy Practices

Notice of Privacy Practices Acknowledgement Form
 
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