Request a Quote

Request a Quote

This form is for employer or organizational business inquiries.
If you are an employee, union member, or eligible family member, click here to access EFAP services and support.
Company or Organization Name
Address where primary worksite or head office is located
Street Address
City
Province / Territory
Postal / Zip Code
Country
Contact Name

First NameLast Name
I am a:

Representative of the organizationBenefits consultant/broker
Phone Number
Please enter a valid phone number.
Work Email
example@example.com
Please indicate which of the following services you would included in your quote:

24/7 Crisis lineProfessional, Short-term CounsellingWork/Life Balance ServicesWorkplace TrainingSupervisor Manager TrainingManagement ConsultationsConflict Resolution/Mediation ServicesCritical Incident/Trauma ResponseLeadership Development/CoachingWorkplace Wellness Programs
Company Size (Approximate Employee Count)
Would you like the EAP to cover the employee's partner/spouse and dependent child(ren)?

YesNo
Does your organization currently have an EAP/EFAP plan in place?

YesNo
If yes, who is your EAP/EFAP provider?
How did you hear about FSEAP?
Please verify that you are human*
Should be Empty: