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“As a Human Resource Director having an EAP is an invaluable resource. Many times the EAP has enabled individual employees and entire work groups to mange or resolve issues so they can move forward“
- HR Director, Healthcare
Keeping People Productive
at home... at work... at life.
Client Satisfaction Survey
Please help us evaluate our services by answering the questions below. Your answers are completely confidential.Thank You.

Please indicate how satisfied you are with the following aspects
of the EAP.
Company Name: (if desired)
Counselor's Name: (If desired)

Please rate each question 1-5 below with the following grade:
1 = Excellent    2 = Good    3 = Neutral    4 = Poor    5 = Very Poor
1. INITIAL CONTACT - the way you were
treated upon contacting the EAP.
   
2. RESPONSIVENESS - the time it took to
see an EAPCounselor
   
3. CONCERN - the way you were treated by
the EAP Counselor
   
4. CONFIDENTIALITY - your confidence that
your contact with EAP was not revealed
without your permission
   
5. EFFECTIVENESS - the extent to which the EAP helped you with your problem
 
6. If you are dissatisfied with any of the aspects listed above, please explain why:
 
REFERRALS TO OTHER SERVICES
7. Did the Employee Assistance Counselor refer you to another service or agency for help?
  (1) Yes  ---- Where:
  (2) No ----- (Skip to question 11)
 
8. If you were referred by the Employee Assistance Counselor, did you use the referral? (Please check only one.)
  (1) Yes
  (2) No ----- (Skip to question 10)
  (3) Does Not Apply
 
9. If you did use the referral given to you by the Employee Assistance Counselor, were you satisfied with the services you received?
  (1) Yes
  (2) No -----please explain why:
  (3) Does Not Apply
 
10. If you did not use the referral, what was the reason?
   
SUMMARY
11. Overall, has there been any change in the problems, which originally brought you to Employee Assistance?
  (1) Change for the better
  (2) Little or no change
  (3) Change for the worse
 
12. Overall, are you satisfied with the Employee Assistance Program?
  (1) Yes

  (2) No -----please explain :
   
13. If you have expressed concerns about the Employee Assistance Program that you want to discuss further and would like an EAP Program Representative to contact you, please enter your name and telephone number below:
Name:
Phone Number:
Best time of day to reach you:
   
14. Do you have any other comments for us about the Employee Assistance Program or the referrals you received?
   
Thank you very much for the time and help in evaluating
our services.
   
Member Area
Employee/Family Information
Manager/Supervisor Information
WorkLife Login
Company Code:
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