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Employee Assistance Program (EAP) Survey
Please help us improve our program by answering the following questions.
1.
Please rate the following items:
Strongly Disagree
Disagree
Agree
Strongly Agree
EAP helped me with my concern.
Strongly Disagree
Disagree
Agree
Strongly Agree
EAP offered a timely appointment (within 5 business days).
Strongly Disagree
Disagree
Agree
Strongly Agree
I would recommend EAP to a co-worker.
Strongly Disagree
Disagree
Agree
Strongly Agree
My job performance improved after EAP services.
Strongly Disagree
Disagree
Agree
Strongly Agree
My physical well-being improved after EAP services.
Strongly Disagree
Disagree
Agree
Strongly Agree
My emotional health improved after EAP services.
Strongly Disagree
Disagree
Agree
Strongly Agree
My personal relationships improved after EAP services.
Strongly Disagree
Disagree
Agree
Strongly Agree
I feel the EAP is a valuable benefit offered by my company.
Strongly Disagree
Disagree
Agree
Strongly Agree
My counselor was helpful and treated me with respect.
Strongly Disagree
Disagree
Agree
Strongly Agree
2.
Prior to coming to EAP:
Strongly Disagree
Disagree
Agree
Strongly Agree
I was missing work.
Strongly Disagree
Disagree
Agree
Strongly Agree
I was late for work or leaving early.
Strongly Disagree
Disagree
Agree
Strongly Agree
My problem required me to be on the phone, email, or internet while at work.
Strongly Disagree
Disagree
Agree
Strongly Agree
I was not able to enjoy my work.
Strongly Disagree
Disagree
Agree
Strongly Agree
My problem kept me from concentrating on my work.
Strongly Disagree
Disagree
Agree
Strongly Agree
I worried about completing my tasks.
Strongly Disagree
Disagree
Agree
Strongly Agree
I could not do my job well because of my personal problems.
Strongly Disagree
Disagree
Agree
Strongly Agree
I was not very satisfied with my life as a whole.
Strongly Disagree
Disagree
Agree
Strongly Agree
Thinking about being at work made me upset.
Strongly Disagree
Disagree
Agree
Strongly Agree
I was unhappy much of the time at work.
Strongly Disagree
Disagree
Agree
Strongly Agree
I dreaded going into work.
Strongly Disagree
Disagree
Agree
Strongly Agree
I often felt anxious at work.
Strongly Disagree
Disagree
Agree
Strongly Agree
Other (please specify)
3.
If EAP referred you to a treatment program, therapist or community resource, please check all that apply:
I followed through with the referral and made contact.
The referral provided me with the help I needed.
I would recommend this referral to others.
The name of the referral: (please specify)
4.
If telehealth was used with your service, please answer the following questions about your telehealth experience.
Strongly Disagree
Disagree
Agree
Strongly Agree
I could clearly see the therapist during the visit.
Strongly Disagree
Disagree
Agree
Strongly Agree
I could clearly hear the therapist during the visit.
Strongly Disagree
Disagree
Agree
Strongly Agree
The telehealth visit was as good as a face-to-face visit.
Strongly Disagree
Disagree
Agree
Strongly Agree
The camera or other telehealth equipment DID NOT make me embarrassed or feel uncomfortable.
Strongly Disagree
Disagree
Agree
Strongly Agree
I would have had to miss work or school if not for the telehealth visit.
Strongly Disagree
Disagree
Agree
Strongly Agree
Overall, I am satisfied with my telehealth visit.
Strongly Disagree
Disagree
Agree
Strongly Agree
Other (please specify)
5.
Other Comments about EAP or a Referral Service