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Are you seeking EAP (Employee Assistance Program) services?

If yes, enter 'Yes' and go to next question. If no, enter 'No' and skip next question.

(EAP REQUESTS ONLY) What is the name of the covered employee and who is their employer?

Covered employee & covered employer

(EAP REQUESTS ONLY) Does the employer have an EAP contract with Audax Psychology Solutions?

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.