Get Employee Assistance Program Client Information Form. Employee Assistance Program Client Information

This guide provides clear, step-by-step instructions for completing the Employee Assistance Program Client Information Form. By following these instructions, users can efficiently fill out the form online, ensuring all necessary information is accurately provided.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Fill in your Employee Assistance Program ID number. This unique identifier helps streamline your case.
3. Enter the date of contact in the designated field to provide a timeline of your consultation.
4. Indicate whether the contact is voluntary or mandatory by selecting the appropriate option.
5. Provide the name of the referring director if applicable.
6. Specify your current work status by selecting from the provided options.
7. Identify the reason for your contact by checking all relevant boxes, such as consultation, assessment, or leave.
8. Fill in your personal data including your name, address, city, postal code, and contact numbers.
9. Provide your email address and date of birth in the specified format.
10. Specify your gender and relationship status by selecting the appropriate options.
11. Indicate your client status, such as teacher or teacher/family, along with the number of persons to consider for financial assistance.
12. Complete the work information section by providing your school name, school district, job classification, and years of service.
13. Select how you learned about the Employee Assistance Program from the provided methods.
14. If a referral is needed, including the name of the counselor and the agency, along with the date of referral.
15. For case action, record any follow-up details including date, method, reason, and results of treatment or intervention.
16. Review all information for accuracy before proceeding. You can then save changes, download, print, or share the form as needed.

Complete the Employee Assistance Program Client Information Form online today to access the support you need.