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Download Forms

Read and print forms in advance

At Solution  Resources EAP, we try to minimize paperwork. We know you want to meet with your counselor as quickly as possible, and not spend a long time completing forms. That's why we have developed the forms that you  can access below: they allow us to collect the minimum demographic information that we need (by law) to identify our files and to collect statistical information for contracted employers in quarterly reports. Please be assured that no employer will receive identifying information about you or your family. Only anonymous statistics are ever released!

Print the forms, complete them, and bring them to your first session. Don’t forget! We need the information to create our files! That way you don't have to be at the session early to complete them, or cut into your valuable session time.

Every client who sees us as part of their employer’s EAP (or a family member’s EAP) will need to complete this set of two forms prior to the first session:

Client Consent and Statistical Data Form (2 pages)

If you are coming to us not through your employer’s EAP, but are using your health insurance or private pay to consult with a therapist, please use the following form:

Insurance-based Consent and Data Form

In some cases, you may want us to share some information with others. For example, when services need to be coordinated with another health care provider (say, your family doctor) or, in some cases, even your employer. In order to allow us to share information, we will need your authorization in writing. The form below will give us that authorization. Please do not complete or sign the form unless you fully and completely understand the instructions and the consequences this authorization may have on confidentiality. If you have any questions about this Release of Information, discuss them with your therapist before signing the form.

Authorization to Release Confidential Information


Solution Resources EAP   509-535-4074

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