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UR Medicine / Employee Assistance Program / Workshops / Workshop/Training Request Form

Workshop Request Form

Please provide four weeks' notice for workshop requests. Any requests received less than four weeks before the requested date cannot be guaranteed. When an EAP counselor is assigned to a workshop, he/she/they will reach out to the requester no less than 24 hours in advance of the workshop time to finalize the number of attendees and the contents of the workshop.

place field "Organization" below
Organization Information
place field "CompanyName" below
place field "Directions" below
place field "ContactName" below
Contact Information
place field "ContactPhone" below
place field "ContactEmail" below
place field "DateTime" below
Workshop Details
   
place field "DatesTimes" below
place field "EmployeeSupervisor" below
place field "Topic" below
place field "NumberAttendees" below
place field "Mandatory" below
place field "StaffNotification" below
place field "Equipment" below
place field "EquipmentOther" below
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