Home Based Telecommuting EvaluationEVALUATION OF HOME BASED TELEWORK
                               (Proponent: DHR, CPAC)
                                      

Check one:  Employee  _____  Supervisor______                                                                      

1.  Were assigned duties accomplished at the home based station? Yes ____ No____

2. If no, please explain why: _________________________________________________

______________________________________________________________________

3.  What amount of workload was accomplished at home? More____ Less____ Same___

4.  Do you feel the program is effective? Yes_____ No_____

5.  Has the program motivated you? Yes_____ No_____

6.   Has the program reduced the stress in you life? Yes___ No____

7.   Was your work environment adequate, i.e. computer, telephone? Yes___ No___

8.   If the answer to question 7 is no, explain_____________________________________

         ________________________________________________________________________

         _________________________________________________________________________

9.   Do you feel the program has improved your quality of life? Yes___ No____

10. Has the program increased your job satisfaction? Yes_____ No_____

11. Did the program have any adverse impact on your office? Yes____ No____


12. If the answer to question 11 is yes, please explain.

_____________________________________________________________________

______________________________________________________________________

13. Would you like to see the program continue? Yes _____ No ____

03/15/10                                  Home Based Telecommuting Home Page