Booking Request

Please complete the form below

Online booking requests will be processed within the next business day.

Our support centre hours are Mon – Fri from 8am – 6pm, Sat 9am – 1pm excluding public holidays

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

Covid-19

For further information about COVID-19 please see the official government website.

Are you currently displaying any flu type symptoms e.g. fever, coughing or difficulty breathing? *

Yes No

Have you had any contact with anyone displaying flu type symptoms in the past 7 days? *

Yes No

Are you vaccinated?

Yes No Undisclosed

Nature of enquiry *

What is the primary reason for support? *

What type of legal advice do you require? *

Please enter details *

How soon do you require assistance from EAP Services? *

Please note: face to face appointments are often booked a few weeks ahead.

Preferred Location *

New Zealand Location

Area *

Location Detail

Name *

Gender *

Date of Birth*

Accessibility Needs

Organisation *

Department/Division *

Your Job Title

What is your preferred method of support? *

Preferred contact method *

Please enter your email *

Please enter your phone number *

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? *

Urgently need help?

As you have identified yourself (or someone else) as being at risk, you are unable to complete this form.

Lifeline

0800 54 33 54

Suicide Crisis Helpline

0508 828 865

Emergency Services

111

Cancel

Urgent appointment

For urgent bookings please call 0800 327 669 during business hours.

Return

Employment/work issue

We are unable to provide legal advice for an employment or work-related issue.

Cancel

Information you provide remains completely confidential and is subject to our Privacy Policy.

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Booking Request

Covid-19

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Log in

Booking Request

Covid-19

Urgently need help?

Lifeline

Suicide Crisis Helpline

Emergency Services

Urgent appointment

Employment/work issue

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