REQUEST A SERVICE/MATERIALS

REQUEST A SERVICE/MATERIALS

I am in a leadership role and requesting assistance.
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Company *
Your Name *
Phone Number *
Example: (123) 123-4567
Email Address *
Workplace Services:

Manager Consultation Workplace Referral Critical Incident Response
Benefits Fair:

I would like to request a health and well-being/benefits fair.
Event Date
Start Time
End Time
Minimum Attendees
Maximum Attendees
Door Prize Requested

Yes No
Event Address

Street Address

Ex. Suite Number

City State

ZIP Code
If you have a theme, please describe it.
If you would like materials and/or handouts on a particular topic(s), please describe your need(s).
First Sun EAP would like to post on our social media channels (e.g. LinkedIn, Twitter, Instagram, etc.) that we are attending an event at your company. In order to do that we need your permission. We would appreciate your consent for us to post our attendance of your event on social media.

Yes, I consent to First Sun EAP to post to social media. No, I do not consent.
Training and Development:

Training Consultation Coaching Employee Orientation Manager Orientation
Potential Date(s)
Preferred Length of Time:

30 Minutes 1 Hour 2 Hours Half Day Full Day
Expected # of Attendees
Describe Your Needs:
Material(s) Requested:
Request Digital Copy

Manager's Guide Manager Brochure Employee Brochure Workplace Referral Flyer Leadership Services Flyer Employee Services Flyer Wallet Card (English) Wallet Card (Spanish) Magnet (English)
Request Print Quantity
Address to send print materials

Street Address

Street Address Line 2

City State

ZIP Code
I would like information on adding these benefits for my employees.

Be Better NOW Cognitive Behavioral Therapy App Identity Theft Services
Type a question
Please verify that you are human *
Please be aware that electronic communication via the internet cannot be guaranteed to be completely free from potential breach of privacy and confidentiality. If security is a concern for you, please call us at 800-968-8143 or in the Columbia, SC area 803-376-2668.
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