Employee Assistance Program (EAP)
Counseling Consent Form

Consent for Counseling

I understand that I am voluntarily participating in the Employee Assistance Program (EAP) counseling services. I acknowledge that the EAP counselor will maintain confidentiality except in situations required by law, such as harm to self or others, child/elder abuse, or court order. Information may be shared with other professionals or the employer only with my written consent.

Confidentiality & Limits

I understand the limits of confidentiality and have had the opportunity to ask questions regarding the counseling process and my rights as a participant. I understand that participation is not a substitute for medical or legal services.

Consent & Acknowledgment

I hereby give my consent to participate in EAP counseling and confirm that I have read, understood, and agree to the terms outlined above.

Employee Signature
Date
Counselor Signature
Date