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.Format: (000) 000-0000.
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 ProgramsWorkplace Culture & Resilience Program
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*
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