In Work Support Service – Client 6 Month Follow Up

The In-Work Support Service undertakes a follow up contact with previous clients to help assess the impact of the support received. As you have accessed the service we would be grateful if you could please take a couple of minutes to answer the following questions.

Client name

Date of birth (DD/MM/YY)

Client ID

Q1. Which one of the following best describes your current employment status? Q1. Which one of the following best describes your current employment status? Employed at work Employed off work due to a physical or mental health sickness absence Self-employed and at work Self-employed and off work due to physical or mental health sickness absence

Q2. Has your employment changed in any of the following ways since you completed your support? Q2. Has your employment changed in any of the following ways since you completed your support? From temporary to stable employment Increase in working hours Moved from involuntary part time work to full time work Moved to a job requiring higher competences/skills, entailing more responsibilities Been promoted Moved to another employer No longer employed / self-employed due to your health condition Other

If any other change, please specify

Q3. If you were on a sickness absence from work when you registered for support, have you returned to work? Q3. If you were on a sickness absence from work when you registered for support, have you returned to work? Yes No Not applicable

If yes, when did you return to work? (DD/MM/YY)

Q4. Has your health condition improved because of the treatment you have received? Q4. Has your health condition improved because of the treatment you have received? Yes No

Q5. Has the support helped you to remain in work? Q5. Has the support helped you to remain in work? Yes No

Q6. Following the support you received are you still using self-help techniques/advice by your therapist? Q6. Following the support you received are you still using self-help techniques/advice by your therapist? Yes No

Q7. Have you any further comments you would like to make? Q7. Have you any further comments you would like to make? Yes No

If yes, please enter your further comments below