EAP Client Response Survey

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Home » Employee Assistance Program » EAP Client Response Survey

Tell us what you think. We care about your opinion.

This form is to be completed after your last EAP session. Please mark your responses by marking the line corresponding to your answer.

How satisfied were you with:
1. The help you received when you called the local or 888 number?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

2. How easy it was to get the EAP services you needed?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

3. Your EAP counselor?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

4. How the EAP services helped you resolve your problem?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

5. How EAP services helped you be more effective on the job?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

6. The overall services you received?
Very Satisfied Satisfied Dissatisfied Very Dissatisfied Does Not Apply

7. Would you recommend the EAP to other employees?
Yes No

Name of EAP Provider:

Location of EAP Provider:

Your Employer:

Comments:

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Your EAP - It's Professional - It's Confidential
Your feedback is very important to us and greatly appreciated.
Thank You.

If you would prefer to fill out the form and mail it back. please download the Client EAP Survey as a PDF. Mailing instructions are provided on the form.