CONCERN: EAP
Satisfaction Survey for Work/Life Services

DATE: __________________

Please take a few moments to tell us how you feel about your experience with our services. Your response is completely confidential and greatly appreciated.

If you are a CONCERN: EAP client, what is the name of your organization?


Which CONCERN: EAP Work/Life Service did you use?

How would you rate how well you were informed about our services before you called?
 Excellent     Very Good     Good     Fair     Poor

How would you rate the helpfulness and pleasantness of the telephone referral staff?
 Excellent     Very Good     Good     Fair     Poor

How would you rate your consultant's knowledge and competency?
 Excellent     Very Good     Good     Fair     Poor

How would you rate the helpfulness of our services in dealing with your problem?
 Excellent     Very Good     Good     Fair     Poor

What is the likelihood that you would use our services again if you needed them?
 Excellent     Very Good     Good     Fair     Poor

What is the likelihood you would recommend our services to your co-workers or
family members?
 Excellent     Very Good     Good     Fair     Poor

What is your overall rating of our services?
 Excellent     Very Good     Good     Fair     Poor

What did you like best about our services?
 

What could we do to improve our services?
 

Other comments?
 

Your counselor’s name (optional): _____________________________

If there is anything about our services that you would like to discuss,
please contact a Clinical Manager at 800-344-4222 or 650-940-7100.
Please fax this survey back to us at (650) 965-2849          Return to Contact page