RACR EAP Enquiry Form

Please select the Type of EAP Service you are enquiring about: *

Employee SupportLeadership Support

Employee Support

Counselling Support: Relationships Australia offers counselling and EAP services to support wellbeing and healthy relationships at home and work. Our counsellors help individuals, couples, and families manage personal, family, and workplace challenges.

Client Details

First Name: *

Surname Name: *

Gender: *

Date of Birth: *

Mobile: *

Email: *

Preferred Contact Method: *

MobileEmail

Residential Address: *

Street Address: *

Suburb: *

State: *

Postcode: *

Workplace:

Workplace Name: *

Client Type: *

EmployeeFamily Member

Service Type:

Counselling Type: *

IndividualCouplesFamily

Support Needs:

Mental Health SupportWorkplace SupportRelationship SupportOther Support

Appointment Type: *

In-Person CounsellingTelehealth Counselling

Leadership Support

Which Service are you enquiring about?

Workplace Mediation:

RACR facilitates problem solving around workplace relationships or issues. Mediation can be with two individuals or with a group. Two mediators are required for a group mediation involving three or more people.

In-Service:

Would you like to learn more about the support available through the Employee Assistance Program (EAP)? We can arrange for a counsellor to visit your workplace to introduce Relationships Australia, explain what to expect from an EAP appointment, and answer any questions you may have.

Early Intervention Support:

Relationships Australia offers a range of customised support options designed to bring staff together in a safe and supportive environment. These sessions are designed to assist staff in their roles and may include facilitated discussions or information sessions focused on problem-solving, skill development, and enhancing wellbeing.

Other:

If you have another enquiry, please enter your details below.

Workplace Details

Name of Workplace: *

Point of Contact: *

Work Phone: *

Work Mobile: *

Work Email: *

Preferred Communication Method: *

Work PhoneWork MobileWork Email

Support Details

Number of Staff: *

Preferred Timeframe or Dates: *

Additional Information: *