EAP Satisfaction Survey or Testimonial for Employers, Managers, and HR

from Employee Assistance of the Pacific, LLC

Mahalo for taking a few minutes to complete the 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.

If you are only providing a Testimonial, please skip to Question #6. Mahalo!

Question Title

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

Question Title

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

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

EAP provider's name:

Question Title

* 3. Do you believe your EAP experience impacted your organization in any of these areas?

	Large positive work impact	Some positive work impact	No work impact	Some negative work impact	Large negative work impact
Employee is missing less work now	Employee is missing less work now Large positive work impact	Employee is missing less work now Some positive work impact	Employee is missing less work now No work impact	Employee is missing less work now Some negative work impact	Employee is missing less work now Large negative work impact
Employee is more present when at work	Employee is more present when at work Large positive work impact	Employee is more present when at work Some positive work impact	Employee is more present when at work No work impact	Employee is more present when at work Some negative work impact	Employee is more present when at work Large negative work impact
Employee is more engaged with their job and/or our company	Employee is more engaged with their job and/or our company Large positive work impact	Employee is more engaged with their job and/or our company Some positive work impact	Employee is more engaged with their job and/or our company No work impact	Employee is more engaged with their job and/or our company Some negative work impact	Employee is more engaged with their job and/or our company Large negative work impact
The employee has more life satisfaction	The employee has more life satisfaction Large positive work impact	The employee has more life satisfaction Some positive work impact	The employee has more life satisfaction No work impact	The employee has more life satisfaction Some negative work impact	The employee has more life satisfaction Large negative work impact
The employee has less work distress	The employee has less work distress Large positive work impact	The employee has less work distress Some positive work impact	The employee has less work distress No work impact	The employee has less work distress Some negative work impact	The employee has less work distress Large negative work impact
There will be less healthcare costs	There will be less healthcare costs Large positive work impact	There will be less healthcare costs Some positive work impact	There will be less healthcare costs No work impact	There will be less healthcare costs Some negative work impact	There will be less healthcare costs Large negative work impact
There will be less drug/alcohol risks	There will be less drug/alcohol risks Large positive work impact	There will be less drug/alcohol risks Some positive work impact	There will be less drug/alcohol risks No work impact	There will be less drug/alcohol risks Some negative work impact	There will be less drug/alcohol risks Large negative work impact
There will be more workplace violence or liability risks	There will be more workplace violence or liability risks Large positive work impact	There will be more workplace violence or liability risks Some positive work impact	There will be more workplace violence or liability risks No work impact	There will be more workplace violence or liability risks Some negative work impact	There will be more workplace violence or liability risks Large negative work impact
There will be less legal liability	There will be less legal liability Large positive work impact	There will be less legal liability Some positive work impact	There will be less legal liability No work impact	There will be less legal liability Some negative work impact	There will be less legal liability Large negative work impact

Question Title

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

Exceeds expectations

Meets expectations

Neutral

Did not meet expectations

Not applicable

Comment (optional)

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* 5. Based on your experience with our EAP:

	Yes	No	Unknown
Would you use EAP again if the need arose?	Would you use EAP again if the need arose? Yes	Would you use EAP again if the need arose? No	Would you use EAP again if the need arose? Unknown
Would you recommend EAP to a co-worker?	Would you recommend EAP to a co-worker? Yes	Would you recommend EAP to a co-worker? No	Would you recommend EAP to a co-worker? Unknown
Would you recommend EAP to a family member?	Would you recommend EAP to a family member? Yes	Would you recommend EAP to a family member? No	Would you recommend EAP to a family member? Unknown
Does the use of your EAP make your job easier?	Does the use of your EAP make your job easier? Yes	Does the use of your EAP make your job easier? No	Does the use of your EAP make your job easier? Unknown
Does the use of your EAP serve your organization's bottom line?	Does the use of your EAP serve your organization's bottom line? Yes	Does the use of your EAP serve your organization's bottom line? No	Does the use of your EAP serve your organization's bottom line? Unknown

Question Title

* 6. We would welcome any testimonial that we could share with prospective customers, either attributed to you or anonymous. (This helps us grow and reduce our costs!)

Question Title

* 7. Your Contact Information (optional)

Name

Title

Company

City/Town

Email Address

Question Title

* 8. If you provided a Testimonial, how should we attribute your comment on our website?

You have my permission to use my Name, Title, and Company on your website. (e.g. Kimo Smith, HR Director, Company X)

You have my permission to use my Name and TItle on your website. (e.g. Kimo Smith, HR Director)

You have my permission to use my Title and Company on your website (e.g. HR Director, Company X)

You have my permission to use my Name and Company on your website (e.g. Kimo Smith, Company X)

You have my permission to use my Name on your website (e.g. Kimo Smith)

You have my permission to use my Title and Location on your website (e.g. HR Director, Kahului)

You have my permission to use my Location on your website (e.g. Kahului)

Please do not use any identifying information.

If there's a different way we should attribute your comments, please enter it here.

Mahalo
for your feedback!
We value any and all feedback to continually improve our services to you, and your Testimonial can help grow our business so we can keep costs down.
Your comments may be lightly edited for website use and to assure confidentiality of anyone using our services.
If you have any additional feedback, don't hesitate to call Dave Mitchell, General Partner, at the number below.

Employee Assistance of the Pacific, LLC
1600 Kapiolani Blvd., Suite 1610
Honolulu, HI 96814
(808) 597-8222
www.EAPacfic.com