from Employee Assistance of the Pacific, LLC

Mahalo for taking a few minutes to complete the nine questions in this confidential survey. It is important to us to provide you with the highest quality of care possible, and we're eager to learn from your experience at the Employee Assistance Program (EAP) in an effort to continually improve our services.

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* 1. What is the name of your Employer/Company?

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* 2. Please rate your satisfaction with obtaining EAP services.

  Exceeded expectations Met expectations Neutral Did not meet expectations Not applicable
The person I talked with on the phone was helpful in answering my questions.
I was treated in a professional, courteous manner.
I was able to obtain services in a reasonable amount of time.
I was able to obtain services in a convenient location.

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* 3. Please rate your satisfaction with the provider you saw.

  Exceeded expectations Met expectations Neutral Did not meet expectations Not applicable
The office was comfortable and clean.
The provider was attentive to me and treated me with compassion and respect.
The provider helped me resolve or cope with the challenge or issue that brought me to EAP.
I would refer a friend or family member to this provider.

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* 4. EAP services with this provider ended because:

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* 5. My life has changed in these areas due to contacting the EAP.

  Improved Stayed the same Worsened Not Applicable
Relationship with spouse/partner
Relationship with children
Relationship with parents or other family members
Self-image (the way I think about myself)
Ability to handle personal problems or stress
Performance at work
Overall quality of life
Other (please list below)

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* 6. Do you believe your EAP experience impacted your work in any of these areas?

  Large positive work impact Some positive work impact No work impact Some negative work impact Large negative work impact
Missing less work now
More present when I'm at work
More engaged with my job/company
More life satisfaction
Less work distress
Less healthcare costs
Less drug/alcohol risks
More job satisfaction
Less emotional distress

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* 7. Rate the overall quality of care and service you received.

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* 8. Based on your experience with our EAP:

  Yes No Unknown
Would you use EAP again if the need arose?
Would you recommend EAP to a co-worker?
Would you recommend EAP to a family member?

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* 9. If you would like to comment on your EAP experience (positive or negative), describe below:

Employee Assistance of the Pacific, LLC
1221 Kapiolani Blvd., Suite 730
Honolulu, HI 96814
(808) 597-8222           www.EAPacfic.com

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