Three forms are to be completed
to initiate a formal referral to EAS:

Please download and fill out your forms clicking on the buttons below. Once these forms are completed and signed, please email them to us as instructed.  Advise the employee to call us for an appointment,  giving him or her a deadline for calling in.  Our office phone number is 205-933-7442.

All forms can be send to:

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Confidential Formal Referral

This form should be completed and signed by the supervisor (or other management representative making the referral) AND the employee.

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Request for Release/ Exchange of Client Information

The form should be completed and signed by the employee and a witness

Communication Between Employer and EAS Regarding Formal Referral

This form tells us how you wish us to deliver information about the employee’s progress. It’s important for us to know what you expect from us.

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