Online Request Form for Workplace Consult or Referral for Mass General Brigham EAP Services

This form is for setting up non-urgent appointments only.


This form is for managers, supervisors, human resources and other leaders that would like a non-urgent consult with the EAP. If your matter is urgent or cannot wait DO NOT complete this form. Please call 866-724-4327 instead.

If your employee or staff member is experiencing a life-threatening situation, please call 911 or immediately send them to a local hospital emergency service.


After you submit the form, we will get back to you within one business day.
* denotes required field
Caller Information
v
v
v
Reason for Contacting EAP
v
Submit