EAP Forms
- CAF-2 - EAP Case Activity and Billing Form (PDF)
- One-Page EAP Case Activity and Billing Form (CAF-1) Frequently Asked Questions (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 (PDF)
- Authorization for Use or Disclosure of Information for Formal or Mandatory Referrals to the EAP (PDF)
- Authorization for Use or Disclosure of Medical Information - DOT Referrals (PDF)
- EAP Participant Statement of Understanding (PDF)
- EAP Participant Statement of Understanding (Español) (PDF)
- EAP Participant Statement of Understanding - Formal or Mandatory Referrals (Español) (PDF)