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Life Management Systems Employee Assistance Program Formal Referral Form Fully completed and signed forms may be securely faxed to (513) 551-1489. Incomplete forms cannot be processed nor used to

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1. Start by carefully reading the indemnity form. Make sure you understand the purpose and implications of signing it.
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3. Provide details of the indemnity agreement. This could involve specifying the parties involved, the date of the agreement, and any relevant reference numbers.
4. Clearly state the scope of the indemnity. Explain the specific risks or liabilities that are being covered by the indemnity.
5. If necessary, include any limitations or exclusions to the indemnity. This may involve stating certain conditions where the indemnity will not apply.
6. Carefully review all the terms and conditions of the indemnity. Ensure that you understand the obligations and responsibilities stated in the agreement.
7. Once you are satisfied with the information you have provided, sign and date the indemnity form in the appropriate sections.
8. If required, have the indemnity form witnessed or notarized according to any specific legal requirements or recommendations.

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