Home
  Home     About Us   Employee Assistance Program Business Risk Management Training & Development
“As a Human Resource Director having an EAP is an invaluable resource. Many times the EAP has enabled individual employees and entire work groups to mange or resolve issues so they can move forward“
- HR Director, Healthcare
Keeping People Productive
at home... at work... at life.
Request for Proposal
Organization Name:
Street Address:
City:
State:
Zip:
Website Address:
Type of Business:
Number of Employees:
Multiple Locations:   Yes     No
    If yes, where are they located?
 
Does the company have an existing EAP?   Yes     No
 
Session model requested:
(you may request pricing on more than one) 		  1-3      1-5      1-6      1-8   
 
Interest in additional services:
*Some services are included in standard EAP proposals and contracts.
  Organizational Development
  Work-Life
  Corporate Health Programs
 Crisis Management/
         Debriefing*
  Risk Management
   Corporate Training & Development*
  Elder Care Planning
  Substance Abuse Program Management/DOT          Compliance
  On-line Services*

 
Other information that would be helpful:
 
Proposal needed by what date:
 
Program implementation date:
 
How did you learn about Southwest EAP?
  Brochure/Marketing
  Word of mouth
   Online search
  Previous work with company
Contact Name:
Title:
Email:
Phone Number:
Fax Number:
If the contact above is a Broker, Consultant or TPA, please complete the following. We will only make contace with your client company if requested by you or your company.
Company Name:
Address:
City:
State:
Zip:
 
Any additional requests:
 
Thank you for the opportunity to provide services to your company.
 
   
 
Member Area
Employee/Family Information
Manager/Supervisor Information
WorkLife Login
Company Code:
Contact Us
24/7 availability
1-800-777-1797












































































  Home     About Us   Employee Assistance Program Business Risk Management Training & Development
Privacy Policy |  Terms of Use      © 2010 Southwest EAP. All rights reserved.