Faculty & Staff Assistance Program

During your initial meeting or 'intake appointment', an FSAP counselor will gather a thorough history from you. Many of our intake sessions are facilitated by a trained graduate-level intern supervised by a licensed mental health provider. Based on information gathered during the intake meeting, FSAP clinicians will determine appropriateness of continued work with your intake counselor or will provide assignment to another FSAP counselor.

DocuSign Information

In support of our University-wide effort to reduce use of paper while also improving efficiency, FSAP now offers DocuSign form completion. DocuSign is our preferred means of receiving client documents. Important: After clicking on a DocuSign form below, you will be prompted to sign into the DocuSign document with your name and preferred email address. Please use the name that you generally print when signing an official document. Use the email address that you prefer FSAP use to communicate with you should you provide email permission. 

Please Note: We request information from all new and previous clients. The documents listed below are requested each year. If (1) year has passed since you last completed FSAP forms, please follow the links below to provide updated information.

DocuSign Forms

Click on the link that includes the name of your counselor. Complete and sign on-line – your documents will auto-send to a secure FSAP email address via DocuSign.

• Telehealth Consent Form
• Authorization to Release/Request Information
• Client Forms - Counselor Paulette Erickson England
• Client Forms - Counselor Esther Horowitz
• Client Forms – Counselor Meridith Antonucci
• Client Forms - Counselor Meredith Lopez
• Client Forms - Counselor Stanley Ly

​​Non-DocuSign Forms

If you prefer completing forms manually, please print, complete and bring to your first session.

• Client Information Form
• SBIRT
• Disclosure - Case Cycle, Case Closures, Surveys
• Rights and Responsibilities
• Addendum - Walking Outdoor Sessions

Non-DocuSign Disclosure Statements

Click on your counselor below; Read, sign and bring to your session.

• Paulette Erickson England
• Esther Horowitz
• Meridith Antonucci
• Meredith Lopez
• Stanley Ly

At times, longer-term counseling could be more beneficial than starting short-term counseling with an FSAP counselor. In these situations, referrals will be made during the initial appointment or at a scheduled follow-up session. In emergency or urgent situations, referral information can also be provided solely via phone, without an appointment. These urgent referrals may be to providers addressing needs related to hospice, eldercare, childcare, basic needs (food, clothing, shelter, energy), and many other issues. While FSAP cannot endorse community providers, we can suggest strategies and resources for finding providers including psychologists, social workers, psychiatrists, and addictions counselors.

FSAP provides guidance and support to supervisors with the following goals in mind:

• Alleviate, reduce, or better manage workplace stressors
• Assist managers and/or supervisors in gaining a better understanding of work setting issues or conflict, and formulate a plan to resolve challenging situations
• Assist with implementation of action plans, follow-up to assess plan efficacy, and identify the need for additional interventions

Supervisor consultation is available to support managers in many situations, including:

• Understanding and managing difficult employee behaviors
• Addressing workplace morale
• Emotional and psychological impact of major workplace decisions and transitions
• Concerning behaviors or sudden shifts the behavior(s) of an employee of concern
• Assisting an employee in finding counseling or other resources
• Communicating effectively with staff members
• Addressing Substance Use and/or Abuse and its impact on the workplace
• Departmental teambuilding 
• Violence in the workplace