Telephone Counseling Forms

Thank you for contacting EAP Solutions. Please review the Personal History Form, The
SPS-6 Questionnaire, and the Statement of Understanding. Then:

• Complete the Personal History Form.
• Complete the SPS-6 Questionnaire.
• Sign two (2) copies of the Statement of Understanding.
• Keep one copy of the Statement of Understanding for your records.
• Mail  the other signed copy along with the Personal History Form and SPS-6 Questionnaire to:

EAP Solutions
112 Washington Place
Suite 400
Two Chatham Center
Pittsburgh, PA 15219

or, fax the documents to 412-647-9484

Please be advised that for counseling to continue, we must have your signed Statement of Understanding. If you need assistance, please contact the National Service Center at
1-800-647-3327.