EAP Evaluation Form

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EAP Evaluation Form

FIT/UCE Employee Assistance Program
A Jointly Sponsored Labor Management Program

YOUR EMPLOYEE ASSISTANCE PROGRAM WOULD LIKE YOUR HELP –
We do need it so we can continue to help you!

We would appreciate your feedback on services you received at the FIT/UCE Employee Assistance Program. It is important that you complete this form for evaluative and funding purposes. Your responses will be used to help us improve our ability to meet employee needs and demonstrate the value of our program. After your last session at the counseling service, please complete the following questions by checking the answers which best express your feelings. Thank you so much for taking the time to complete this brief survey.

*This form is confidential and your name/user name is not recorded.

Did you receive a call from a counselor within what you felt was a reasonable period of time?

Yes

Clear selection

Were you helped by the counseling service?

Yes

Clear selection

Are you satisfied that our services were confidential?

Yes

Clear selection

How many in-person and/or virtual sessions did you have with the EAP counselor?

How many telephone sessions did you have with the EAP counselor?

Did the location of the EAP office meet your needs for confidentiality?

Yes

Other:

Clear selection

Please share any impressions/feedback about the location of the EAP office.

If you believe the counseling service helped improve your ability to do your job in any of the following ways, please indicate all that apply.

Attendance improved

Punctuality

Meeting deadlines

Relationships with co-workers

Relationship with superior

Attitude

Quality of work

Quantity of work

Use of time on the job

Concentration

Not applicable

Other:

Were there problems with your job situation that you needed help with that you did not receive?

Yes

No, counseling helped my situation

No, my problems were not connected with or affecting my job

Clear selection

Has this experience changed your opinion about counseling?

No, no change

Yes, more positive

Yes, more negative

Clear selection

Did your counselor refer you to a community resource outside of the counseling service?

Yes

Clear selection

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