Participant Satisfaction Survey - Deer Oaks Employee Assistance Program (EAP)

Thank you for recently accessing your Employee Assistance Program. Your EAP is a free and confidential benefit for your and your family. For purposes of quality assurance and improvement, Deer Oaks as well as your employer, are interested in your feedback regarding the EAP services you received. The results of this survey, when given to your employer, do not include your name or any identifying information. This survey is also available on the web for ease of completion and return, so that you do not have to fax, mail or bring your survey in to your provider. Please take a moment to rate your degree of satisfaction with the services you received.

General Information

First name:

Last name:

Date:

3/9/2010 5:09:25 PM

Employer:

Department:

City

County

Name of person accessing benefit:

Who received services:

	Employee
	Dependent
	Both

Location where you received services:

Name of your EAP counselor:

Date service received:

/ /

Type of service received:
Please mark for all services received.

	Telephonic counseling
	Short-term face-to-face counseling
	Legal, financial, health plan, or community referral
	Prevention / education
	Other:

Satisfaction Survey

Please use the following scale to rate your satisfaction with the EAP services you received from Deer Oaks EAP Services. If the question is not applicable, please circle "N/A". Please feel free to make any additional comments.

On A Scale From 1 - 5
1 = "Not Satisfied" or "No"
3 = "Somewhat Satisfied" or "Maybe"
5 = "Very Satisfied" or "Yes"

If the question is not applicable, please select "N/A".

Not Satisfied

Somewhat Satisfied

Very Satisfied

1. Ease of accessing your EAP

N/A

2. Initial telephone triage

N/A

3. Availability of appointments

N/A

4. Convenience of location of services

N/A

5. Telephonic counseling (if applicable)

N/A

Not Satisfied

Somewhat Satisfied

Very Satisfied

6. Short-term Face-to-Face counseling

N/A

7. Prevention / Education materials provided by the therapist

N/A

8. Responsiveness, professionalism & knowledge of therapist

N/A

9. Referrals to Legal, Financial, Community Services or Insurance Health Plan (helpful, specific, easy to access)

N/A

10. Would you refer a friend to the EAP or come back again yourself if you needed to access your EAP benefit?

N/A

11. Responsiveness and professionalism of office staff (if applicable)

N/A

12. Needs were met through counseling

N/A

13. Counseling goals were met in a timely manner

N/A

14. Website (ease of use, information on site)

N/A

15. Overall satisfaction with services

N/A

Not Satisfied

Somewhat Satisfied

Very Satisfied

Comments

We appreciate any feedback or comments you are willing to share so that we may continue to improve our services. Please use the space provided for feedback.

Thank You.