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Employee assistance program supervisor referral form - douglascounty-ne 2026
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- Click ‘Get Form’ to open the Employee Assistance Program Supervisor Referral Form in the editor.
- Begin by entering the date, your name as the supervisor, and your phone number at the top of the form.
- Next, input the employee's name in the designated field. This identifies who you are referring for assistance.
- Evaluate each criterion listed below. For job performance, check 'NA' if not applicable or select a rating from 1 (Not a Problem) to 7 (Very Serious Problem) for each sub-section.
- Provide specific comments or attach documentation where necessary to clarify your evaluation.
- Repeat this process for employee behavior and attendance sections, ensuring all relevant fields are completed accurately.
- Once finished, review your entries for accuracy before submitting. You can save and share this form directly through our platform.
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Faculty and staff do not need a referral from a manager or supervisor to use these services. Employee Assistance Program (FSEAP) Omaha, NE 68182-0789