Information and Forms for Currently Contracted Providers
EAP Network Contracted Provider Guidelines:
As a Provider, you can always find the most current Guidelines for Contracted EAP Providers. The Guidelines include an overview of the EAP Program, the role and responsibilities of an EAP Provider, and expectations about service provision, documentation, and billing.
EAP Provider Application Form:
Contracted providers can add or update information using our provider application form. This includes hours of operation, clinician's profile (optional), skills/specialties, and accepted insurance.
EAP Client Records Forms:
- Authorization for Use or Disclosure of Protected Health Information
- Organizational Service Report
- Organizational Service Invoice
Attention EAP Providers:
PROVIDERfiles, our new secure online case documentation and management system is now available for providers to register and receive referral notifications via email. If you are a current EAP provider and wish to start going paper-free, please email: firstname.lastname@example.org to register.