Training Solutions and
Organizational Development
Strategies

Providing support and direction during a difficult
life season

"We saved money by investing in our employees, instead of replacing them."

Keeping priorities
in balance with
Work-Life Services

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Affiliate forms

The following forms (in .pdf format) are available for download by All Points EAP Affiliates:

Instructions

At the first session with the client, please go over the Statement of Understanding of EAP services (SOU) and have all present over the age of 14 years sign.  Return this SOU form and the completed two page Assessment/Closure form (opening ratings on page one and an open note on page two) within 10 days of first session.  You may include a reimbursement form at this time.

The Notice of Privacy Practices must be given to the client at the first session and is theirs to keep.

Intake and follow up notes may be kept on the affiliate's own forms / electronic forms or may use All Points EAP's intake form(s) below.  Our goal is to reduce the affiliate's time taken with unfamiliar forms by allowing use of individuals/organizations own documentation processes.  All documentation is to be done in accordance with ethical, legal, and regulatory requirements.

  • Intake/Assessment Form (OPTIONAL)
    You may use the first 2 pages only for Routine Assessments or use all 4 pages for Complex Assessments.  (Different from the Assessment/Closure form.)

  • Case Activity Forms  (OPTIONAL)
    May be used for follow up sessions in place of your own documentation.

At the close of services, again complete the closing ratings on page one and the closing note and referrals on page two of the Assessment /Closure form and return with the Reimbursement form for payment.  If a self referral was requested by the client, then you must include a copy of the Waiver of Referral form as well.  Documentation needed for payment should be returned within 60 days of the last appointment.

All paperwork may be returned to All Points EAP via fax at 434-845-1253 or via mail to:

All Points EAP
2250 Murrell Road, Suite B5
Lynchburg, VA 24501

Do you have questions or feedback?  Feel free to call us anytime at 800-645-1246.