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Contact Instep 04 382 8071
Investors In People
SlideShow
EAP Checklist
A. Details (email address is required)
Name
 Role
 Organisation
Phone
 Fax
 Email

A. General
1. Does your organisation have an EAP? Yes No
2. If Yes, are you interested in comparing your existing service with a proposal from Instep? Yes No
3. If Yes, are there any aspects of EAP service delivery that interest you more than others?
Employee access
 Manager access
 Cost
 Additional Services (Education, training etc)
 Performance based reporting
 Critical incident response
4. If No, are you interested in a proposal from Instep? Yes No
5. Is your organisation an ACC Partnership Programme member? Yes No
6. If No, are you interested in ACC's Work Safety Management Practices Programme that may attract up to a 20% rebate on your ACC premium? Yes No

B. Workplace Issues
7. Indicate whether any of these issues are of concern to your organisation:
Absenteeism
 Excessive sick leave
 Accidents
 Near misses
 Fatigue
 Workplace conflict
 Alcohol and/or drug abuse

C. Cover
8. Family members at same address to be covered? Yes No
9. Employees require EAP cover outside New Zealand? Yes No
10. If yes, how many employees?
11.Any other stressors. e.g. anger, depression, budgeting etc. List them here:
12. Critical incidents included in EAP cover? Yes No

D. Utilisation
13. Prepared to pay for counselling for employees? Yes No
14.If yes, a maximum number of sessions
per employee per issue?		 3.5.Other.

The information gathered in this checklist will be treated in strict confidence and not disclosed to any third party without express permission of the client organisation.


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PO Box 19240
Wellington 6149
Ph.: 04 382 8071
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