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Request-a-Quote Form

MHN can reduce the cost of employee depression, substance abuse and emotional problems. Give us a few simple numbers and we'll estimate your savings with our ROI calculator!

Broker/Consultant Form

* Required Fields

Broker/Consultant Company *

Contact Name *

Phone Number *

Email *

Street Address

City

State

Zip

Client Name

Client number of employees *

Client's Street Address

Client's City

Client's State *

Is this client currently a customer of MHN?

yes no

What products and services would you like to learn more about? (Click and hold Ctrl to select multiple)

If other, please specify

Employer/Client Form

* Required Fields

Company Name *

Number of Employees *

Contact Name *

Phone Number *

Email *

Street Address

City *

State *

Zip *

Are you a current client of MHN?

yes no

What products and services would you like to learn more about? (Click and hold Ctrl to select multiple)

If other, please specify

Email us at requests@mhn.com to receive additional information about our products and services.