Follow Us
Blog
Walmsley Is My EFAP
Login
EMPLOYEE AND FAMILY ASSISTANCE PROGRAMS
REQUEST A COUNSELLOR
HOME
ABOUT
CONTACT
EMPLOYER SERVICES
The case for EFAP's
Walmsley EFAP
Resources for Employers
Wellness Initiatives
Wellness Resources
Awareness Campaigns
EMPLOYEE SERVICES
Employee and Family Assistance Program
Request a Counsellor
Blog
WELLNESS LIBRARY
Family
Substance Misuse
Trauma
Resilience
Emotional Health/Wellness
Work/Career
Work/Family/Life Balance
Request a Counsellor
I am covered by my employers EFAP:
Yes
No
I am employee:
Yes
No
If Yes: what is the company name?
Employee First Name :
Employee Last Name :
Employee Date of Birth:
My First Name:
My Last Name :
I am seeking counselling for:
Myself
Spouse/Child/Other dependent
Personal Information (required):
Home Mailing Address
Street Address
City
Province
Select One
BC
AB
Postal Code
Ok to send correspondence
Yes
No
Telephone
Landline
Ok to leave message
Yes
No
Cell
Ok to leave message
Yes
No
Work
Ext
Ok to leave message
Yes
No
Email
Preferred method of contact
Phone
Email
Text
Best time to contact:
Tell us about the person(s) seeking services:
(please include the names of all individuals that would be in attendance for sessions)
First Name
Last Name
Date Of Birth
Gender
Relation
Add More
--- Select One---
Male
Female
--- Select One---
Spouse
Son
Daughter
Step-son
Step-daughter
Ex-husband
Ex-wife
Grandchild
Other
General issue that will be addressed with the counsellor?
Additional information:
Submit
