Evaluation Form
EVALUATING THE ASSISTANCE THAT YOU RECEIVED FROM THE EAP WILL HELP US PROVIDE
THE BEST POSSIBLE SERVICE TO YOU. PLEASE SEND US YOUR ANONYMOUS RESPONSE:
  1. I was given prompt attention.
    Yes No Not Applicable
  2. The initial phone counselor was courteous/understanding (compassionate).
    Yes No Not Applicable
  3. I was helped with my questions/concerns.
    Yes No Not Applicable
  4. My productivity at work has improved as a result of using the EAP service.
    Yes No Not Applicable
  5. If I hadn't used the EAP, I would have needed to take time off from work to resolve these issues.
    Yes No Not Applicable

    6. PLEASE ANSWER THE FOLLOWING QUESTIONS IF APPLICABLE:

  6. The face-to-face counselor was courteous/understanding (compassionate).
    Yes No Not Applicable
  7. I was satisfied with the information I received.
    Yes No Not Applicable
  8. I was satisfied with the referral I received
    Yes No Not Applicable
  9. Comments:
  10. Name of Company:
  11. Name of Counselor: