Forms

Image of person filling out a form Image of person filling out a form

Faculty and Staff

FSAP Intake Forms - Please download, complete, and save to your desktop. Then return the completed intake document to UMFSAP@miami.edu. Reference these simple instructions if you like, or call our office with any questions.

Per University of Miami (Administrative Leave Policy), faculty and staff may attend up to three (3) FSAP visits per treatment episode on administrative time.

Supervisors / Managers

Formal Supervisory Referral Form - Referring agent (i.e. HR representative, supervisor, manager, etc.) - Please call the FSAP 305-284-6604 before offering a formal supervisory referral to any employee so we may clarify how this process works and lend pointers for appropriately extending this offer of support. This form may be used to formalize this process but it is not the only means of making a formal referral to our services. If you choose to use this form, simply download, complete and return it to UMFSAP@miami.edu after consulting with our team.

Per University of Miami (Administrative Leave Policy), all faculty and staff attending FSAP as part of a Formal Supervisory Referral, or a condition of employment shall be afforded administrative leave to cover their absences from work for the duration of these visits.