Employee Wellness Program Evaluation Form

Employee Wellness Program Evaluation Form

EMPLOYEE INFORMATION

Name:

[Your Name]

Department:

[Your Company Department]

Position:

[Position/Role]

Date of Joining Wellness Program: 

[MM-DD-YYYY]

PROGRAM EVALUATION

Please rate the following aspects of the Wellness Program on a scale of 1 to 5 (1 = Poor, 5 = Excellent):

1. Overall Satisfaction with the Program:

  • 1

  • 2

  • 3

  • 4

  • 5

2. Quality of Wellness Activities (e.g., fitness classes, health seminars):

  • 1

  • 2

  • 3

  • 4

  • 5

3. Effectiveness in Improving Personal Health:

  • 1

  • 2

  • 3

  • 4

  • 5

4. Communication and Support from Program Coordinators:

  • 1

  • 2

  • 3

  • 4

  • 5

5. Availability and Accessibility of Program Resources:

  • 1

  • 2

  • 3

  • 4

  • 5

6. Impact on Workplace Morale and Team Spirit:

  • 1

  • 2

  • 3

  • 4

  • 5

CONSENT FOR USE OF FEEDBACK:

I hereby consent to [Your Company Name] using my feedback to improve the Wellness Program.

Employee Signature: _______________________

Date: [MM-DD-YYYY]

FEEDBACK AND SUGGESTIONS 

Participating in the wellness program significantly improved my work-life balance and overall job satisfaction





FUTURE PARTICIPATION:

Would you be interested in participating in future wellness programs?

  • YES

  • NO

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