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Manager / Supervisor
ACI Services
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ACI Training
Supervisory Referrals
Utilization Reports
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Training Survey
Supervisory Referral Survey
Please fill out the questionnaire as completely as possible. Red items are a required field.
Are you an Employee or Family Member
Employee
Family Member
Name of the Employer who sponsors the E.A.P.
Title of Training Session
Name of the trainer
Date of Training
Was the Trainer professional and courteous?
Please Select
Yes
No
Was the information delivered helpful?
Please Select
Yes
No
Was the information delivered timely?
Please Select
Yes
No
Was the E.A.P. benefit explained well at the start of the training?
Please Select
Yes
No
Did the Trainer refer you to other professional services?
Please Select
Yes
No
Did you contact or utilize any of those services?
Please Select
Yes
No
Were those services helpful?
Please Select
Yes
No
Overall, in terms of the training you received, do you feel that the training was:
Please Select
Completely Appropriate
Significantly Appropriate
Moderately Appropriate
Not Appropriate
In terms of overall satisfaction with the EAP service, how satisfied are you with this benefit?
Please Select
Very Satisfied
Satisfied
Dissatisfied
Would you recommend the E.A.P to your co-workers?
Please Select
Yes
No
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5414 Oberlin Dr. Suite 240, San Diego, CA 92121
Phone: (800)932-0034 Email:
webmaster@acieap.com
