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EAP Forms

  • CAF-1 - EAP Case Activity and Billing Form (PDF)
  • CAF-2 - EAP Case Activity and Billing Form (PDF)
  • One-Page EAP Case Activity and Billing Form (CAF-1) Frequently Asked Questions (PDF)
  • Military OneSource Case Activity Form (PDF)
  • Authorization to Disclose Health Information (Word)
  • Authorized Representative Form (Word)
  • Revocation of Authorization to Disclose Health Information (Word)
  • Revocation of HIPAA Authorized Representative Form (Word)
  • Authorization to Disclose Information for Formal or Mandatory Referrals to the EAP (Word)
  • Authorization to Disclose Health Information for Formal or Mandatory Referrals to the EAP (EspaƱol) (Word)
  • Authorization to Disclose Health Information for Department of Transportation Referrals (Word)
  • EAP Participant Statement of Understanding (PDF)
  • EAP Participant Statement of Understanding (Español) (PDF)
  • EAP Participant Statement of Understanding - Formal or Mandatory Referrals (PDF)
  • EAP Participant Statement of Understanding - Formal or Mandatory Referrals (Español) (PDF)

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