EAP Questionnaire

Have you made use of the Employee Wellness Programme?

Yes

No

Do you know where to find the EAP toll-free number?

Yes

No

Are the members of your household aware that they can make use of the Employee Wellness Programme?

Yes

No

What changes to the Employee Wellness Programme would you like to see in future?

If you have not used any of the services, please indicate your reason(s) for not doing so.

I have not needed to use the service, but will do so should there be a need

I do not know how to use the service

The service is not available in my home language

I do not believe the service is confidential

I might get into trouble at work

I had a previous bad experience with a employee wellness programme

Someone at work might find out that I have a problem

I do not feel ready to address my problems

OtherOther

Tick all that apply

If you have made use of the employee wellness programme, use the scale below to indicate how you would rate your overall wellbeing since you made use of the programme.

1 - Major improvement, 2 - Slight improvement, 3 - Stayed the same/no change, 4 - Worsened 5 - Not applicable

Would you recommend the Employee Wellness Programme to a friend or a colleague?

Yes

No

If you have any complaints or compliments with the service that you received through the Employee Wellness Programme and would like to be contacted, please leave your contact number and or email address below.

Name

Name and contact number is optional

Phone

Email