APEGA Service Inquiry Form

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Your FIRST Name *

Your LAST Name *

Your Primary Phone Number *

Your Preferred Email Address *

Your Company *

Which city is your company located in? *

Your APEGA Email Address (Applicable only if you are an APEGA staff member)

CORPORATE SERVICES - What service(s) are you interested in for your employees/members? *

Employee/Member Counselling

Employee/Member Assessment

MyPsychPulse Scan

Workshops

Lunch and Learn

Management Support/Consult for Psychological Health and Safety Programs and Issues

Management Case Consult on Employee Mental Health and Addictions Cases

Team Intervention and Support

Critical Incident Debriefing

Harassment and Bullying Investigation

Return-to-work Assessment for Psychological Injury

Other or unsure, but would like to speak to someone about my options

Required

Brief description of what you are looking for: *

Thank you!

We will be in touch very shortly.

For corporate/organizational service inquiries, please call Richard, our Corporate Client Manager, at 780-203-2273

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