Associated Employee Assistance Services of WI, Ltd.

To contact an EAP counselor or schedule an appointment, please call 1.800.540.3758

Please submit the following form and we will contact you.

We would like to send you more information about our Employee Assistance and other programs. Please complete the form below so that we may send you additional materials.

Contact Information

Your Name:
Job Title:
Your Company Name:
Company Address:
City:
State:
Zip:
Number of Employees at your Company:
Number of Locations:
Phone:	- ext.
Email:
Do you currently have an EAP?
Comments:

Please check the boxes you would like information about

	Services available through AEAS, I am an employer and would like to know more about your programs.
	Cost savings and other benefits of EAP.
	Provider services/ credentialling, I am an EAP counselor interested in becoming a part of your network.
	Employee orientation information, I am an employee and would like to know more about services available to me.

Associated Employee Assistance Services of WI, Ltd.