To schedule an appointment or request services, please complete the following form or call us at 1-800-344-1011.

[[[["field9","equal_to","Counseling"]],[["show_fields","field16,field15,field12,field18,field19"]],"and"],[[["field16","contains","Religion"]],[["show_fields","field17"]],"and"],[[["field9","equal_to","Work Life Services"]],[["show_fields","field20"]],"and"]]
1 Step 1
Counseling Request Services
Best time to call
Ok to leave message?
How did you hear about the EAP?Select all that apply
Details of your request for services
Provider Preference
Best times to meet with a counselorPlease select all that apply