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Would you like to become a contracted provider?

If you are a licensed counselor or therapist that would like to become a contracted provider for CONCERNED associates employee assistance, please open the PDF file Provider Application to print out and complete the application to become a Concerned Associate.

Please mail your completed application to our office: 3612 13th St. Menominee, MI 49858.

Our Network Development Specialist may get in touch with you about contracting with CONCERNED associates employee assistance if and when there is a need in your geographical area. (Please be advised we only accept providers with a minimum of 3000 supervised hours and fully licensed and certified in their state.)

Please email the following information: info@concernedassociates.com
• Your legal name:
...First, Middle Initial and Last Name
• Your Business Email address:
• Your Organization
• Your Business Address
• Your Business Telephone Voice and Fax Numbers
• After Hours Phone
• Your website address
• Please tell us how you found us
• Please ask any questions you would like

Thank you for inquiring with CONCERNED associates employee assistance. Once we receive your application in the mail we will enter your information in our data bank.


PLEASE NOTE:
Are you an Independent Certified Employee Assistance Professional (CEAP)?
Please be advised, if you hold a current CEAP credential, we may wish to offer you a CONCERNED associates Representative Contract to provide specific services in your area.

This contract includes:
• a negotiated premium rate for your direct service.
• specific rate for employee orientations and training.
• professional paid commission incentives for marketing in your area.

If you are interested, please make a note of this in your email communications.
Thank you for your interest in CONCERNED associates.

E-mail your inquiry to:
info@concernedassociates.com

EAP Conselor
PDF Provider Application
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