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EAP Intake Form
All fields are required.

 
  • Headspace: the email you received is your authorization; sessions are valid for 90 days.

  • Compsych/Guidance Resources: If you don't have an email/letter with a specific expiration date, please call them. Sessions are usually valid for 3-5 months.

  • Aetna, Optum and Cigna, please make sure you have a valid authorization. 

Thanks! We will reach out to schedule your first appointment!

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