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Request a Quote

If you are a company or union interested in seeing how fseap can assist your workers and their family members, or if you'd like a quote, please complete the form below.

For an employee assistance program provided by fseap:
* = required



Name of Organization that will sponsor the EAP:*

City/province where primary work site is located:*

Other work locations (please list by city/province):

Number of employees who will be covered by EAP:*

		Send quote to:

Contact Name:*
Position Title:


I am a:*		Representative of Sponsoring Organization
		Benefits Consultant


Company Name (if different from Sponsoring Organization):

Address 1:*
Address 2:
City:*
Province:*
Postal Code:*
Phone:*
FAX:
E-mail:*


		Please indicate which of the following services you would like included in your quote (check as many as apply):*

		psycho/social counselling 24-hour telephone crisis line financial/credit counselling legal advisory services child/elder care information teen/parent hotline wellness seminars supervisor/manager training critical incident/trauma response

other services (please list):


		OPTIONAL: Additional information about the Sponsoring Organization

		Industry/Sector: government health/social services education public/protective services public utilities telecommunications transportation financial services computer/technical services legal/accounting/engineering services wholesale/retail/business sales insurance/real estate accommodation/food service manufacturing other

		Employee groups include (check as many as apply): administrative support data entry clerks sales/marketing personnel computer technicians drivers/couriers legal/financial professionals health/home care workers medical professionals law enforcement officers skilled tradespeople machine operators other

Organization is unionized?		Yes No

Comments:


	fseap Vancouver Suite 300, 1665 West Broadway Vancouver, British Columbia V6J 1X1 T 800.667.0993 T 604.732.6933 F 604.739.4353