177 Sims Pkwy

Harrisburg, NC 28075 US

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M2H Forms

If you're a new client and have been provided your username and temp password please click on the client portal tab to complete your paperwork.

If you are apart of our EAP services we have provided your EAP company's Statement of Understanding Forms for you to complete and email to us. The email address for forms is [email protected]. Please be sure to add your full name, EAP servicer, authorization or reference number, how many sessions and phone number in the email so we can identify who you are. If you don't have all of this information please communicate this in the email.

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Authorization to Release Information

Click here to view and Download form

Download

HeartShip Application

Click here to view and Download form

Download

Referral

Click here to view and Download form

Download

Empathia EAP Statement of Understanding

Click here to view and Download form

Download

Evernorth/Cigna EAP Statement of Understanding

Click here to view and Download form

Download

Military OneSource EAP Statement of Understanding

Click here to view and Download form

Download

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