EAP Downloadable Forms
In this section, you will find all the forms that you need when accessing Employee Assistance Program services.
If you are 18 years or older and are scheduled for your first-ever appointment with an Employee Assistance Professional, download and complete the English or Spanish version of the Application for Services--Adult. If the appointment is for a family member who is 17 years of age or younger, the English or Spanish version of the Application for Services—Child should be completed.
If you have received Employee Assistance services in the past and it has been greater than six months ago, download and complete the Adult or Child Re-Admission form.
For Valley Baptist Health System employees seeking emergency funds during a personal financial crisis, read the eligibility guidelines. If you feel that you meet these guidelines, Please click on the link to apply online Emergency Fund Online Form.
Supervisors who want to make a performance-related referral to the EAP should download, complete and FAX the Supervisor Referral Screening form. Be sure and call the EAP office to discuss your concerns about the employee and to obtain an appointment time.
- Application for service - Adult
- Application for service - Child
- Spanish Application for service - Adult
- Spanish Application for service - Child
- Adult Re-admission
- VBHS Employee Emergency Fund Application
- Supervisory Referral Instructions
- Supervisory Referral Form
- Supervisor Refererral Consult with Supervisor
- Supervisor Refererral Authorization to Exchange and/or Disclose Info