Substance Abuse in the Work Setting
This Confidential Survey is intended to gauge employer interest in Employer Support Programs.
Employer Support Programs are designed to help local businesses address challenges in the workplace to reduce turnover costs and retain workers by aligning them with resources they may need to address personal problems and manage the demands of home and work life that are causing interference with productive work.
I currently serve as
Owner of the company
Chief decision maker for the company
How many employees currently work at your business or organization?
1 - 2
3 - 14
15 - 50
51 - 100
Which category best describes your business or organization?
Manufacturing or Industry
Medical or Health Services
Construction or Contracting
Does your company or organization experience any of the following?
Low customer satisfaction
Excessive absences or tardiness
Excessive accident compensation claims
Page 1 of 4
Never submit passwords through Google Forms.
This form was created inside of Mental Health Association in Chautauqua County.
Terms of Service