Employee assistance program supervisor referral form - douglascounty-ne 2026

1. Click ‘Get Form’ to open the Employee Assistance Program Supervisor Referral Form in the editor.
2. Begin by entering the date, your name as the supervisor, and your phone number at the top of the form.
3. Next, input the employee's name in the designated field. This identifies who you are referring for assistance.
4. 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.
5. Provide specific comments or attach documentation where necessary to clarify your evaluation.
6. Repeat this process for employee behavior and attendance sections, ensuring all relevant fields are completed accurately.
7. Once finished, review your entries for accuracy before submitting. You can save and share this form directly through our platform.

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