Client Termination Form

Client Information

Required fields are designated with an *

*Company Name:

*Company EHX ID:

*Product Selection:

Applicant Tracking System (ATS)

Onboarding I-9

E-Verify

Work Opportunity Tax Credit

Affordable Care Act (ACA)

*Requested Last Access Date:

*Main Contact Name:

*Main Contact Title:

*Main Contact Email:

*Main Contact Phone:

*Reason for Termination:

Additional Reason for Termination and/or Feedback:

*Product Rating: Select 1 2 3 4 5

*Customer Service Rating: Select 1 2 3 4 5

Submit