Client Information and Notice of Privacy Practices


1. What is Employee Assistance of the Pacific and what are EAP (or PAP) services?

Employee Assistance of the Pacific, LLC is Hawaii’s largest provider of Employee Assistance Program (EAP) and Physician Assistance Program (PAP) services. EAP and PAP services are a short-term counseling and referral service, the purpose of which is to assist employees with resolving personal problems that may be interfering with work or disrupting their lives. Employers provide these services at no charge to employees or physicians.

2. What happens if I miss a session?

You are asked to call at least 24 hours in advance to cancel your appointment. Late cancellations or no-shows may be subtracted from your total annual benefit.

3. What about confidentiality?

Confidentiality is extremely important. Brief records are kept only to assist in evaluation and treatment and are not made a part of your personnel or medical files. Information obtained during our contacts will not be revealed to any person or agency outside EAP without your written consent.

If your employer has formally referred you to EAP, your counselor will inform you as to the limited information that we will need to provide your employer per your signed release. Only with your signature may your counselor reveal any limited confidential information with your employer.

EAP counselors may disclose information and records to the EAP as needed for coordination of EAP services, quality assurance, and/or payment. may be required by law to disclose information to appropriate authorities under certain conditions. They include:

  1. Threat of bodily harm or death to another person or yourself;

  2. Abuse or neglect of a child or elder;

  3. A legitimate subpoena issued by a court of law for information specifically described in the subpoena; and

  4. As required by federal or state laws.

If you have provided an email address and consent, you understand that you may receive electronic information including referral, resource, and survey material from the EAP/PAP. By providing this consent you understand that this emailed information may not be secure, and you may retract this consent at any time by calling the EAP/PAP.




By law we are required to ensure that your PHI is kept private. The PHI constitutes information created or noted by EAP that can be used to identify you. It contains data about your past, present, or future health or condition, the provision of health care services to you, or the payment for such health care. The EAP is required to provide you with this Notice about our privacy procedures. This Notice must explain when, why, and how EAP would use and/or disclose your PHI. Use of PHI means when EAP would share, apply, utilize, examine, or analyze information; PHI is disclosed when EAP releases, transfers, gives, or otherwise reveals it to a third party outside of EAP. With some exceptions, EAP may not use or disclose more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made; however, EAP is always legally required to follow the privacy practices described in this Notice.

Please note that EAP reserves the right to change the terms of this Notice and our privacy policies at any time. Any changes will apply to PHI already on file with EAP. Before EAP makes any important changes to policies, we will immediately change this Notice and post a new copy of it in the office and on the website. You may also request a copy of this Notice from us, or you can view a copy of it in our office.


EAP will use and disclose your PHI for many different reasons. Some of the uses or disclosures will require your prior written authorization; others, however, will not. Below you will find the different categories of EAP uses and disclosures, with some examples.

A. Uses and Disclosures Related to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. EAP may use and disclose your PHI without your consent for the following reasons:

  1. For treatment. EAP may disclose your PHI to physicians, psychiatrists, psychologists, social workers and other health care professionals in an emergency situation.

  2. For health care operations. EAP may disclose your PHI within our organization to facilitate the efficient and quality measures of our EAP to review the quality of the overall services that you have received or to evaluate the performance of the employee assistance professionals who provided you with these services. AGENCY may also provide your PHI to EAP attorneys, accountants, consultants, and others to make sure that we are in compliance with applicable standards and or laws.

  3. To obtain payment for treatment. EAP may use and disclose your PHI to bill and collect payment for the EAP services provided or a business associates, such as billing companies, claims processing companies, and others that process health care claims for EAP.

B. Certain Other Uses and Disclosures of your PHI Do Not Require Your Consent.

  1. When disclosure is required by federal, state, or local law; judicial, board, or administrative proceedings; or law enforcement.
  2. If disclosure is compelled by a party to a proceeding before a court of an administrative agency pursuant to its lawful authority.
  3. If disclosure is required by a search warrant lawfully issued to a governmental law enforcement agency.
  4. If disclosure is compelled by the patient or the patient’s representative pursuant to Health and Safety Codes or to corresponding federal statutes of regulations, such as the Privacy Rule that requires this Notice.
  5. To avoid harm, PHI may be provided to law enforcement personnel or persons able to prevent or mitigate a serious threat to the health or safety of a person or the public.
  6. If disclosure is compelled or permitted by the fact that you are in such mental or emotional condition as to be dangerous to yourself or the person or property of others, and if I determine that disclosure is necessary to prevent the threatened danger.
  7. If disclosure is mandated by the Child Abuse and Neglect Reporting law if there is a reasonable suspicion of child abuse or neglect.
  8. If disclosure is mandated by the Elder/Dependent Adult Abuse Reporting law if there is a reasonable suspicion of elder abuse or dependent adult abuse.
  9. If disclosure is compelled or permitted by the fact that you tell me of a serious/imminent threat of physical violence by you against a reasonably identifiable victim or victims.
  10. If disclosure is compelled or permitted by the fact that you report the commission of or contemplation of a commission of a crime.
  11. For public health activities.
  12. For quality review health oversight activities.
  13. For specific government functions which impact national security, or veterans or military personnel.
  14. For research purposes which may result in improved practices.
  15. For Workers' Compensation compliance purposes.
  16. If an arbitrator or arbitration panel compels disclosure.
  17. If disclosure is required or permitted to a health oversight agency for oversight activities authorized by law, such as HIPAA compliance.
  18. If disclosure is allowed by law for purposes of Public Safety under Department Of Transportation regulations.
  19. If disclosure is otherwise specifically required by law.

C. Certain Uses and Disclosures Require You to Have the Opportunity to Object.

Disclosures to family, friends, or others. Your PHI may be provided to a family member, friend, or other individual who you indicate is involved in your care or responsible for the payment for your health care, unless you object in whole or in part. Retroactive consent may be obtained in emergency situations.

D. Other Uses and Disclosures Require Your Prior Written Authorization.

In any other situation not described in Sections IIIA, IIIB, and IIIC above, your written authorization will be obtained before using or disclosing any PHI. Even if you have signed an authorization to disclose your PHI, you may later revoke that authorization, in writing, to stop any future uses and disclosures (assuming that we haven't taken any action subsequent to the original authorization) of your PHI.


These are your rights with respect to your PHI:

1. The Right to See and Get Copies of Your PHI.

You have the right to see your PHI, or to get copies of it; however, you must request it in writing. If EAP does not have your PHI, but knows who does, we will advise you how you can get it. You will receive a response from EAP within 30 days of our receipt of your written request. Under certain circumstances your request may be denied. If that is the case, EAP will give you, in writing, the reasons for the denial. Your right to a denial review will be explained as well. Copies of your PHI will not exceed $0.25 per page. With your approval you may be provided a summary or explanation of the PHI, as well as to the cost, in advance.

2. The Right to Request Limits on Uses and Disclosures of Your PHI.

You have the right to ask that EAP limit the use and disclosure of your PHI. While EAP will consider your request, we are not legally bound to agree. If EAP does agree to your request, we will put those limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that EAP is legally required or permitted to make.

3. The Right to Choose How We Send Your PHI to You.

It is your right to ask that your PHI be sent to you at an alternate address or by an alternate method. EAP is obliged to agree to your request providing that we can give you the PHI, in the format you requested, without undue inconvenience.

4. The Right to Get a List of the Disclosures Made by EAP.

You are entitled to a list of disclosures of your PHI that EAP makes. The list will not include uses or disclosures to which you have already signed a consent/authorization for; uses or disclosures that are used for treatment, payment, or health care operations; or information sent directly to you or to your family. The list will also not include disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 14th, 2003. Your request for an accounting of disclosures will be responded to within 60 days of receiving your request. The list will include disclosures made in the previous six years, beginning as of April 14th, 2003, unless you indicate a shorter period. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed and the reason for the disclosure. This list is provided to you at no cost, unless you make more than one request in the same year, in which case charges based on a set fee for each additional request will apply.

5. The Right to Amend Your PHI.

If you believe that there is some error in your PHI or that important information has been omitted, it is your right to request that corrections be made to the existing information or add the missing information. Your request and the reason for the request must be made in writing. You will receive a response within 60 days of our receipt of your request. Your request may be denied in writing, if it is found that: the PHI is (a) correct and complete, (b) forbidden to be disclosed, (c) not part of EAP records, or (d) original source is other than EAP. A denial must be in writing and must state the reasons for the denial. It must also explain your right to file a written statement objecting to the denial. If you do not file a written objection, you still have the right to ask that your request and our denial be attached to any future disclosures of your PHI. If your request is approved, EAP will make the change(s) to your PHI, inform you that the changes have been made, and advise all others who need to know about the change(s) to your PHI.

6. The Right to Get This Notice by Email

You have the right to get this notice by email. You have the right to request a paper copy of it, as well.


If, in your opinion your privacy rights have been violated, or if you object to a decision made about access to your PHI, you are entitled to file a complaint with the person listed below. You may also send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W. Washington, D.C. 20201. If you file a complaint about AGENCY privacy practices, no retaliatory action will be taken against you.



If you have any questions about this notice or any complaints about EAP privacy practices, please contact David Mitchell, General Partner, Employee Assistance of the Pacific LLC, 1-808-597-8222


If you choose to use Telehealth services (e.g. over the phone or via a video connection) you do so with several understandings in place, including: (a) These services are not for emergencies. (b) These services are not appropriate for high-risk individuals (e.g. risk of suicide or harm, drug and alcohol issues) or for children. You should seek emergency help or follow-up care when in a high risk situation or when recommended by your Provider. (c) You are providing consent for this service delivery model understanding that we cannot control your confidentiality to the same degree as face-to-face, in that we cannot control who is overhearing your phone or video conversations and we cannot control who has access to your phone or computer. (d) You understand that delays in evaluation or provision of services may occur due to failure of electronic equipment. (e) You understand that your Provider, in his or her sole discretion and professional judgment, may determine that telehealth services are not appropriate for some or all of your needs and, accordingly, may elect not to provide telehealth services to you. In addition, by completing online documents you are authorizing us to use your electronic signature for all documents, agreements, and attachments (collectively, the "Documents") and consent to permit an electronic signature (as of the nature currently in use by the EAP/PAP) in lieu of hand-written signatures on any one or more of the Documents.



November 4, 2021

Client Intake Form (TEST)

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Invalid Acknowledgment

I understand this form, including the confidentiality in the EAP/PAP and the limitations to confidentiality, and accept it as the terms of my participation in the program. I understand that my participation is voluntary and that I can discuss any questions with my counselor during my first visit.

Client Information

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Please enter the Best Phone Number to Reach You

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If you are not the employee with EAP benefit:

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Background Information

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Please enter your Type of Medical Insurance

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What Brings You In?

Please describe your reason for contacting us

Please let us know how long has this been a problem for you

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Please let us know what would you like to accomplish by coming here

Please let us know how serious this problem is for you

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Please enter more details about the problem(s)

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Five Final Questions

Below are a series of statements that refer to aspects of your work and life experience that may be affected by the personal problems you want to address at EAP during the past 30 days. Please read each item carefully and answer as accurately as you can.  Remember that your answers will not be shared with your employer.

Invalid Number of Work Hours Missed


The following statements reflect what you may do or feel on the job or at home.  Please indicate the degree to which you agree with each of the statements for the past 30 days. 

You need to fill out the field: My Personal Problems Kept Me from Concentrating on My Work

You need to fill out the field: I Am Often Eager to Get to the Work Site to Start the Day

You need to fill out the field: So Far, My Life Seems to be Going Very Well

You need to fill out the field: I Dread Going to Work

Invalid Client Signature


If client is under the age of 18, Parent or Authorized Representative Signature is also required:

Invalid Input

Invalid Relationship to client

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Hawaii's Largest
Employee Assistance Program

Keeping Hawaii Employees
Healthy, Safe, and Productive

Helping the Bottom Line
Of Over 200 Hawaii Employers

Hawaii's Largest
Employee Assistance Program

Keeping Hawaii Employees
Healthy, Safe, and Productive

Helping the Bottom Line
Of Over 200 Hawaii Employers

Hawaii's Largest
Employee Assistance Program

Keeping Hawaii Employees
Healthy, Safe, and Productive

Helping the Bottom Line
Of Over 200 Hawaii Employers

Hawaii's Largest
Employee Assistance Program

Keeping Hawaii Employees
Healthy, Safe, and Productive

Helping the Bottom Line
Of Over 200 Hawaii Employers

Affiliate Providers


This is a password-protected page

To view the list of providers, enter the password here:

Call the office at (808) 597-8222 if you need the password.

Coronavirus (COVID-19) Information, Resources, Articles & Websites

 coronavirus bannerWe will be continuing to provide updated information on this page that we hope helps you as this global pandemic continues, and as all of us continue to face any challenges dealing with this new reality.

We know that this Coronavirus (COVID-19) is impacting employees and their families, as well as companies worldwide, and want to support you any way we can.


VIDEO TRAININGScoronavirus concern poster

Couple conflict 100

A 43-minute training on the mental health issues One Year Into COVID-19 (March 2021)





A 45-minute training on Working, Communication, and Time Management:Working Communication and Time Managment and COVIDTips for working in this Global Pandemic (Sept. 2020)





Our 22-minute training for Employers developed for the Hawaii Chamber(May 28, 2020) chamber training screenshot





Our 45-minute training for Educators (May 17, 2020) Education Coronavirus Video





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Our second 26-minute video: "Fear, Anxiety, and Grief: EAP and Coronavirus" (April 24,2020)





Fear and Anxiety First Slide

Our first 30-minute video: "Fear and Anxiety During a Global Pandemic" (April 2, 2020)





We are here to help you while keeping appropriate social distancing that protects you as well as our providers. You can access our services in two ways:


Phone strip

Call us and we will arrange for an appointment with a counselor through the phone.


Telehealth strip

Call us and we will arrange for an appointment with a counselor through a secure online video platform.

We can also help you by connecting us to our experts who can help you with the following issues:

More for Employees

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Please note that all links on this page are external links. Employee Assistance of the Pacific is not responsible for the content in these links.

Tips for Working from Home

 employees self assessment

WIth many of working from home, we found some articles that may help you do it successfully!


COVID-19 and Mental Health

 employees articles

We have included a wide variety of articles which we hope you find helpful.


 002 prospective customers

We have provided a variety of website links that may help employees with their relationships.


 002 prospective customers

We have provided a variety of website links that may help employees with their keiki

Online 12-Step Meetings

 002 prospective customers

Here are some links for online (phone or video) 12-step meetings:


 employees links

We have provided a variety of website links that may help employees with a variety of issues!


Furlough, Layoff, and Termination Information: Resources, Articles & Websites

coronavirus bannerIn light of the challenging business climate we find ourselves in due to the COVID-19 global pandemic, we wanted to provide you with some resources your company may find helpful in dealing with any furloughs, layoffs, or terminations that may occur.

We have included a variety of articles, downloadable flyers, and website links appropriate for a variety of situations and audiences, so please be thoughtful how and when you distribute these. Some are appropriate for those being furloughed/laid off/terminated, some are appropriate for their managers, some are appropriate for those still working -- the "survivors."

We are here to help you any way we can during these challenging times.


Layoff and Furlough Articles and Flyers

  • 1


Please note that all links on this page are external links. Employee Assistance of the Pacific is not responsible for the content in these links.

Current Articles Related to the Coronavirus

 employees self assessment

Here are some recent articles published specifically in response to the Coronavirus that may help:


Other Helpful Articles

 employees articles

We have included a wide variety of links to additional articles which we hope you find helpful.



Layoff Survivor 101

Responding to the loss of a job is often the same as with other losses:
btn download orange
  1. Denial
  2. Anger
  3. Fear
  4. Depression
  5. Acceptance
Acknowledge the loss.
Possible Reactions:
  • Fear/insecurity/worry/anxiety
  • Sadness
  • Anger
  • Withdrawal
  • Guilt
  • Relief
  • Anticipation
Maintain Good Self-Care.
  • Nutrition
  • Sleep
  • Exercise
  • Uplifting activities
Ignore rumors.
  • Seek accurate information instead
Keep communication channels with your boss open.
Empower yourself.
  • Update your resume.
  • Increase networking opportunities.
Take control of your budget.
Two coping strategies:
  • Use solution-focused thinking — designed to eliminate problems
  • Reduce symptoms — to lessen the sense of hardship you are experiencing


Take time to review

what you can and cannot

realistically control.

 I can control

I cannot control

My time The unexpected
 My attitude Others' attitudes 
How I treat others How others treat me
How I treat myself What people think, say, and do
My emotions Others' emotions
My reactions Others' reactions

You and your family members are eligible to see, at no cost to you, a professional counselor through your Employee Assistance Program.
Call us at (808) 597-8222 to schedule a time to meet with a counselor near you. All services are strictly confidential.

Supporting Transgender, Non-Binary, and/or Gender Nonconforming Employees

Rainbow Trans Heart

Making the workplace an inclusive and affirming place for employees who are transgender, non-binary, and/or gender nonconforming is not only a legal mandate, it is the right and pono thing to do. All of us have the right to safely express our gender identity, be judged by our merit and ability, and to be free from discrimination and harassment based on protected classifications.

Your EAP is here to support individuals facing challenges in transitioning, “coming out,” or dealing with challenges along the way. We are also here to support teams and companies who are doing their best to support these employees so that all employees can perform to their full potential. Recognizing that the recruitment and retention of a diverse workforce is essential to successful organizations, we wanted to let you know we are available for supporting these issues, as well as providing you with some additional resources that may help you move forward.


Please note that all links on this page are external links. Employee Assistance of the Pacific is not responsible for the content in these links.

 employees self assessment

Here are some recent articles that may help:


Also, many large cities (e.g. Seattle, Denver), governmental organizations (e.g. NASA, DOL, military branches), and universities have also published guidelines on best practices for supporting gender transition and gender non-conforming issues. These are easily obtained through a simple web search (e.g. "Gender Transition University Guidelines" or "Nonconforming Gender Issues Guidelines").

Our Well-Being Campaign

Well Being Campaign Logo

Our EAP is fully committed to helping individuals and companies with their overall Well-Being. We launched our Well-Being Campaign in 2017, making it a cornerstone of what we offer.

We see Well-Being as something that is bigger and more comprehensive than Wellness.

Gallup Polls consistently finds that here in Hawaii we rate high (usually the highest state!) in overall Well-Being because we seem to do better than most places at balancing the five pillars of Well-Being:

Gallup 5 pillars of well being pie chart









Read more

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If you don’t have an EAP, want to understand how EAP can help your bottom line and provide a positive ROI, or want to know more about us and how we’re different, we can help!

Read more

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Employer Groups

If you want to know how to get the most value from your EAP, how to best use our services, or how to refer an employee who could benefit from our services, we can help!

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and Managers

If you want to know how to refer an employee who could benefit from our services, how EAP can support your career, and get tools to make your job easier, we can help! 

Read more

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If you want to know what your EAP benefit is, how it can help you, the kinds of services you and your family can get, how to use it, and make sure it’s all free and confidential, we can help!

Read more