Evaluation Forms
 

Below is a confidential and anonymous Evaluation form of services received. The requested information is for our use only.  Please provide information as accurately as possible.  We are committed to provide the highest quality of services to employees and their families.  Please answer yes or no to the following questions by clicking yes or no button. If the question does not apply ignore the question.  Any comments or requests can be typed in the spaces provided below.  When you are finished completing the form click the "SUBMIT" button at the end of your questionnaire. Thank you for your courtesy and cooperation.

Date          Example: 10 25 2001
Are you or your company a participating employees assistance services member?		yes no
If not, how did you here about us?		Go to Comments - Requests
Were you treated with courtesy?		yes no
Did the EAP address your concern(s)?		yes no
Were you given an appointment within 3 days?		yes no
Were you treated in a confidential manner?		yes no
If you were referred, was the referral helpful?		yes no
Was information received from our website?		yes no
Was information received over the telephone?		yes no
Was information received in person (during a consult with your EAP counselor)?		yes no
Was information received during workshop?		yes no
Was the speaker knowledgeable?		yes no
Would you use the EAP services again?		yes no
If you would like a reply enter your email address:
Date of last service? (12-2005)

Comments - Requests:

Thank you for  helping us evaluate New Bridge Employees' Assistance Service(s).