Employee Assistance Program Enquiry
Interested in hearing more about The Mind Room's EAP Services? Please provide us with some background details and we will give you a call back.

PLEASE NOTE: This form is for organisational enquiries. If you are an individual and would like to book an appointment, please click 'Book Now' in the top right hand corner.
Name (Contact Person) *
Organisation Name *
Your Role *
How many people are in your organisation? *
Email Address *
Mobile phone number *
Your location (city/suburb/State) *
Is there anything else we should know?
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This form was created inside of The Mind Room.