Get the free EAP FormalMandatory Referral Form - Carilion Clinic

CARILLON EAP REFERRAL FORM For EAP Consultation Email form to: Fax form to: 5409818957 Conner carilionclinic.org or call 8009921931 modern carilionclinic.org FORMAL: Work Performance OR MANDATORY

How to fill out eap formalmandatory referral form

How to Fill Out EAP Formal Mandatory Referral Form:

1. Obtain the form: Contact your employer's Human Resources department or EAP (Employee Assistance Program) coordinator to request a copy of the EAP formal mandatory referral form. They will provide you with the necessary paperwork.
2. Personal Information: Start by entering your personal information at the top of the form. This typically includes your name, employee identification number, job title, department, and contact information. Ensure that all the details are accurate and up to date.
3. Reason for Referral: Indicate the reason for the referral in the designated section. This might include issues related to mental health, substance abuse, workplace conflicts, personal distress, or any other concern affecting your well-being or job performance.
4. Supervisor's Information: Fill in the required information about your immediate supervisor or manager. Include their name, job title, contact details, and any additional information as requested on the form. This section is crucial for maintaining proper communication between the supervisor and the EAP.
5. Referral Source: State who is referring you to the EAP. It could be self-referral or a referral made by a supervisor, co-worker, family member, or HR representative. Include their name and contact details to establish proper communication channels.
6. Assistance Needed: Specify the kind of assistance or support you require from the EAP. It can be counseling, therapy, substance abuse treatment, legal or financial guidance, or any other service that the EAP offers. Be clear and concise in describing your needs.
7. Availability: Indicate your availability for EAP services based on your work schedule and preferred timings. This information helps the EAP coordinator match you with appropriate resources and schedule appointments that are convenient for you.
8. Release of Information: Consent to the release of necessary information between your employer, the EAP, and other involved parties. This ensures proper coordination and confidentiality in dealing with your situation.
9. Signature: Sign and date the form to authenticate your consent and agreement with the information provided. This signifies your willingness to participate in EAP services and engage in the process of seeking help or support.

Who Needs EAP Formal Mandatory Referral Form?

1. Employees: Any employee who requires assistance dealing with personal issues, mental health concerns, substance abuse problems, or other challenges that may affect work performance can benefit from the EAP formal mandatory referral form. It serves as a crucial tool for seeking appropriate support and resources.
2. Supervisors: Supervisors or managers who notice employees struggling emotionally, demonstrating behavioral changes, or experiencing difficulties that may impact their performance should consider making a formal mandatory referral. The form allows supervisors to initiate the process of getting their employees the help they need.
3. HR Representatives: HR representatives play a vital role in addressing employee well-being and ensuring a healthy work environment. They may use the EAP formal mandatory referral form to refer employees who require support for any reason, ranging from personal problems to workplace conflicts.

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What is eap formalmandatory referral form?

The EAP Formal Mandatory Referral form is a document that must be completed when an employee is required to attend an Employee Assistance Program (EAP) due to work-related issues.

Who is required to file eap formalmandatory referral form?

Employers are required to file the EAP Formal Mandatory Referral form for employees who are mandated to attend an Employee Assistance Program.

How to fill out eap formalmandatory referral form?

The EAP Formal Mandatory Referral form can be filled out by providing the employee's information, the reason for the referral, and any additional details required by the employer or EAP provider.

What is the purpose of eap formalmandatory referral form?

The purpose of the EAP Formal Mandatory Referral form is to ensure that employees receive necessary support and assistance for work-related issues in a timely manner.

What information must be reported on eap formalmandatory referral form?

The EAP Formal Mandatory Referral form must include the employee's name, contact information, reason for referral, supervisor's information, and any other relevant details.