SEAP Enrollment Form

Retention Insurance for Your Workforce — Invest in employee wellbeing and watch productivity soar

24/7 Support

Confidential assistance available anytime, anywhere

100% Confidential

Employers receive insights only—never personal details

Proven Results

Improved retention, productivity, and workplace morale

Enroll Your Organization

Primary Contact

Full Name *

Job Title *

Email *

Phone Number *

Program Needs

Services Needed (select all that apply) *

24/7 Crisis Intervention

Stress & Burnout Support

Financial Wellness Coaching

Manager Consultations

Professional Referral Network

Current Workforce Challenges *

Preferred Start Date *

Additional Information

Confidentiality Commitment

Shamalie HR's SEAP program maintains strict confidentiality. All employee interactions are private. As the employer, you will receive utilization insights and monthly snapshots, but never personal details about individual employee concerns or conversations.

I understand and agree to the confidentiality terms of the SEAP program. *

We'll contact you within 24 hours to discuss program details, pricing, and implementation.

Have Questions?

Call us at (954) 477-2607 or email [email protected]