Request an Appointment with EAP Services Limited

Name *

Organisation *

Business group

Site (location)

How soon do you require assistance from EAP Services? *

Are you at risk of hurting yourself or others? *

Yes No

Do you have any concerns for your safety at work or at home? *

Yes No

Do you have concerns about relationship violence? *

Yes No

We'll be sending your appointment confirmation, reminders and surveys to your email address. We'll never share your email address with anyone. Do you approve? *

Yes No

Please enter your email address *

Preferred contact method *

Contact email address *

Alternate contact method *

Number *

Request Type *

What is the nature of your enquiry? *

What type of legal advice do you require? *

Please enter details *

What is your preferred method of support? *

Preferred Country *

Country *

City *

Suburb *

What day of the week best suits you for support services? *
Any Monday Tuesday Wednesday Thursday Friday Afterhours/weekend

What time of day best suits you? *

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Booking Request

If you require immediate attention please contact our National Support Centre 24/7 on freephone 0800 327 669

Menu

Login

Booking Request

If you require immediate attention please contact our National Support Centre 24/7 on freephone 0800 327 669

Employment/work issue

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