Concern EAP Client Feedback Question Title * 1. What was the date of your session? Date / Time Date OK Question Title * 2. My session was conducted in person at the office. using telehealth (MyChart). by telephone. OK Question Title * 3. The scheduler that helped me is named Albretta Linda Jay Someone else I do not remember their name Someone else OK Question Title * 4. The person who assisted me in scheduling my session was helpful. Strongly Agree Agree Do not agree or Disagree Disagree Strongly Disagree OK Question Title * 5. The name of my counselor is Linda Tamara Cynthia Brandon Melani Darin Priscilla Tracey Brittanay Shunda Ashley Kim I do not remember their name Other (please specify) OK Question Title * 6. My Counselor started our session on time. Yes No The session did not start on time because I personally was running late. OK Question Title * 7. When I was with the counselor I felt accepted not judged. Strongly Agree Agree Do Not Agree or Disagree Disagree Strongly Disagree OK Question Title * 8. My Counselor made an effort to get to know me and my counseling needs. Strongly Agree Agree Do Not Agree or Disagree Disagree Strongly Disagree OK Question Title * 9. I plan to or already have scheduled a follow up appointment. Yes No Maybe/ I'm still trying to decide OK Question Title * 10. Overall, How would you rate the quality of the services provided by Concern? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied OK Question Title * 11. Please provide any feedback (positive or negative) along with any other questions or comments that you have below. Also, if you would like to be contacted confidentially by Concern leadership, please provide your name along with the best way to contact you (phone number, email address, etc.) OK THANK YOU FOR YOUR TIME!