Understanding your Personal and Professional Concerns:
Excellent Good Adequate Poor Unacceptable N/A

Communicating Clearly and Effectively:
Excellent Good Adequate Poor Unacceptable N/A

Keeping You Informed of Progress:
Excellent Good Adequate Poor Unacceptable N/A

Meeting Timescales:
Excellent Good Adequate Poor Unacceptable N/A

Working with you to meet your personal goals:
Excellent Good Adequate Poor Unacceptable N/A

Providing Value for your time:
Excellent Good Adequate Poor Unacceptable N/A

Responding Promptly to Problems:
Excellent Good Adequate Poor Unacceptable N/A

Meeting Overall Goals:
Excellent Good Adequate Poor Unacceptable N/A

Job Performance:
Excellent Good Adequate Poor Unacceptable N/A

Attendance:
Excellent Good Adequate Poor Unacceptable N/A

Relationships with Co-workers:
Excellent Good Adequate Poor Unacceptable N/A

Relationships with Family Members:
Excellent Good Adequate Poor Unacceptable N/A

Availability of our Providers to see you:
Excellent Good Adequate Poor Unacceptable N/A

Privacy of your EAP meeting
Excellent Good Adequate Poor Unacceptable N/A

What level of confidence do you have in us to deliver the services that you require:
Complete Alot Some Little None

Who referred you to the Workplace Solutions' EAP Program:
Self Supervisor Co-Worker Personnel/Health-services Other

Did your Workplace Solutions Provider refer you to an outside resource:
Yes
No

Did you use the referral?
Yes
No

Please let us know how the referral helped you:

Based on our performance, would you refer our services to someone else?
Certainly Very Likely Somewhat Likely Unlikely Very Unlikely

Please share with us the reason for your above answer.

If you have any suggestions regarding how we could improve the services we provide to you, please enter them in the box below.

Please let us know if we may contact you for a personal conversation about our services. Give us the best way to get in touch with you and the best time to do so. As always, your privacy and the confidentiality of any communication with you is our priority.