New Jersey Division of Temporary Disability and Family Leave Insurance Website

Customer Feedback Survey

We are redesigning our website for Temporary Disability and Family Leave Insurance. We are seeking feedback from customers like you to help us improve our services for all customers. The survey will take just a few minutes to complete. We appreciate your time.

Question Title

* 1. What was your main reason for visiting our website today? (Please choose one.)

Question Title

* 2. What type of device did you use to access the website?

a mobile device (cell phone, tablet/iPad)

a desktop or laptop computer

Question Title

* 3. How would you rate your experience with the current Temporary Disability and Family Leave Insurance website?

	1 (Poor)	2 (Fair)	3 (Good)	4 (Excellent)
Score	Score 1 (Poor)	Score 2 (Fair)	Score 3 (Good)	Score 4 (Excellent)

Please explain your answer.

Question Title

* 4. I am a(n):

New Jersey Worker (Claimant)

Employer

Medical Provider

TDI/FLI Professional

Question Title

* 5. Please tell us how important the following website features are to you:

	1 (Not Important)	2	3	4 (Very Important)
Ability to file a claim online	Ability to file a claim online 1 (Not Important)	Ability to file a claim online 2	Ability to file a claim online 3	Ability to file a claim online 4 (Very Important)
General program information	General program information 1 (Not Important)	General program information 2	General program information 3	General program information 4 (Very Important)
Email support	Email support 1 (Not Important)	Email support 2	Email support 3	Email support 4 (Very Important)
Web chat support	Web chat support 1 (Not Important)	Web chat support 2	Web chat support 3	Web chat support 4 (Very Important)
Telephone support	Telephone support 1 (Not Important)	Telephone support 2	Telephone support 3	Telephone support 4 (Very Important)
Video tutorials and/or step-by-step guides	Video tutorials and/or step-by-step guides 1 (Not Important)	Video tutorials and/or step-by-step guides 2	Video tutorials and/or step-by-step guides 3	Video tutorials and/or step-by-step guides 4 (Very Important)
Printable literature/pamphlets	Printable literature/pamphlets 1 (Not Important)	Printable literature/pamphlets 2	Printable literature/pamphlets 3	Printable literature/pamphlets 4 (Very Important)
Frequently Asked Questions (FAQ)	Frequently Asked Questions (FAQ) 1 (Not Important)	Frequently Asked Questions (FAQ) 2	Frequently Asked Questions (FAQ) 3	Frequently Asked Questions (FAQ) 4 (Very Important)
Forms library (explanation of all Temporary Disability and Family Leave Insurance forms)	Forms library (explanation of all Temporary Disability and Family Leave Insurance forms) 1 (Not Important)	Forms library (explanation of all Temporary Disability and Family Leave Insurance forms) 2	Forms library (explanation of all Temporary Disability and Family Leave Insurance forms) 3	Forms library (explanation of all Temporary Disability and Family Leave Insurance forms) 4 (Very Important)
Translation into a language other than English (please specify language in box below)	Translation into a language other than English (please specify language in box below) 1 (Not Important)	Translation into a language other than English (please specify language in box below) 2	Translation into a language other than English (please specify language in box below) 3	Translation into a language other than English (please specify language in box below) 4 (Very Important)

Other language

Question Title

* 6. Please describe anything additional you would like to see on the Temporary Disability and Family Leave Insurance website that is not included in the list above.

Question Title

* 7. What type of specific information and/or materials would you like to see included on the website (e.g., roadmaps, visual guides, printable pamphlets, application tutorials?)

Question Title

* 8. What subject areas would you like to see covered on the Temporary Disability and Family Leave Insurance website?

Question Title

* 9. Would you be willing to test our new website once it is developed?

Yes

No

If so, please provide your email address below.

Question Title

* 10. (Optional) Please provide your contact information:

Name

Email address