EAP Appointment Request

Book a confidential
EAP counselling appointment

The Employee Assistance Program is a completely confidential service. The details you enter below will only be used to complete the registration process and book your counselling session. Once you have submitted your request, we will call you or SMS you within 1 business day to confirm your session booking details.

If you require urgent counselling assistance, please call Assure Programs on 1800 808 374
If you require emergency assistance, please call 000

onsite EAP
Details about you:

Firstly, just a couple of details about you so we can register you for our services.

Date of Birth*
(Required for identity verification when confirming the appointment)

(We will use this information to help connect you with a local Psychologist )
State*

How did you learn about the EAP?*

Details about your organisation:

We capture this information only for statistical reporting purposes. If you are an employee, accessing EAP through your organisation, please complete your employment details below. If you are accessing EAP through a family member's workplace, please complete your family member's employment details below.

(Family members can also be eligible to access EAP)

How long have you or the employee worked with this company?*
How do you, or the employee work with this company?*

Details about your appointment request:

We use these details to connect you with one of our highly experienced Psychologists.

Choose an Appointment Location*

What dates or times are you available?:
First Choice (day)*

First Choice (time)*

Second Choice (day)

Second Choice (time)

Third Choice (day)

Third Choice (time)

Do you require a Psychologist who works specifically with the following clients: