Note that Sheppard Pratt encourages supervisors to refer troublesome employees for counseling. Despite Akin Gump's allegations that I had interpersonal problems at the firm and that I was "very difficult to supervise," my supervisor never referred me for counseling to Sheppard Pratt.
The Sheppard Pratt Employee Assistance Program and their affiliates have been retained by your employer to offer you confidential consultation at no charge.
Assessment and referral services offered to employees and their family members has been prepaid on a contractual basis by your employer. If Employee Assistance Program staff or Affiliates should recommend further care at a treatment agency or with a private practitioner, the cost of that treatment will be your responsibility. Often the cost can be defrayed by your company's medical benefits; however, not all counseling is reimbursable under every policy. Although we make every effort to refer you to an individual or agency with whom you can use your benefits, the ultimate responsibility for verification of coverage is yours. You should, thus, check with your benefits department and/or insurance company to verify your coverage.
Confidentiality - Information regarding your use of the Employee Assistance Program will not be given to anyone outside of the EAP except in cases where there is imminent threat of suicide, homicide or abuse of others.
Self-referrals - If an employee or family member comes in for assistance, no one will be notified of the individual's use of the Employee Assistance Program, unless the individual signs a Release of Information Form.
Supervisory Referrals - If an employee contacts the EAP as a result of a referral from their supervisor for job performance problems, you may be asked if you wish to sign a Release of Information form to allow us to confirm your attendance at EAP. Nothing regarding the personal concern will be discussed unless you authorize it in writing on the Release.
Voluntary Participation - Use of the Employee Assistance Program is voluntary. Employment or advancement in the corporation is not affected by the employee's decision to use or not to use the services. The corporation evaluates an employee on the basis of his or her work performance, not his or her use of he program.
I HAVE READ THIS FORM AND UNDERSTAND ITS CONTENTS.
/s/ Gary Freedman
/s/ Judy Peres, MSW
COUNSELOR OF AFFILIATE NAME/TITLE