Online EASI Form exceptions:

You must submit the EASI Form (PDF) by fax or mail only for the following EAPs.

  • Federal Aviation Administration Management Substance Abuse Evaluation referred case or Mandatory Referral
    • Fax: 888-656-5032  
    • Address: Attn: Affiliate Specialist, MO22 PO Box 1899 Maryland Heights, MO 63043
  • Department of Transportation Substance Abuse Professional case or Mandatory Referral
    • Fax: 888-656-5032
    •  Address: Magellan Healthcare, Inc. FOH Team MO22 PO Box 1899 Maryland Heights, MO 63043
  • Department of Energy or Nuclear Regulatory Commission Substance Abuse Expert case or Mandatory Referral 
    • Fax: 888-656-5032 
    • Address: Magellan Healthcare, Inc. FOH Team MO22 PO Box 1899 Maryland Heights, MO 63043
  • Magellan employee EAP case
    • Contact 1-866-266-2376 for the custom EASI Form. Submission is by mail only.

If you need assistance, return to MagellanProvider.com and use the Chat with us button to reach a representative.