Customer Feedback: NJ Division of Temporary Disability and Family Leave Insurance Website Survey

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

a mobile device (cell phone, tablet/iPad)

a desktop or laptop computer

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* 2. How would you rate your experience with the information pages on the redesigned 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. (optional)

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* 3. How would you rate your experience accessing claim information or starting a new claim application from the 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. (optional)

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* 4. How would you rate the look and feel of the new site?

	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. (optional)

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* 5. Please tell us how hard or easy it was to find the following:

	1 (Hard)	2	3	4 (Easy)
Basic information about each program	Basic information about each program 1 (Hard)	Basic information about each program 2	Basic information about each program 3	Basic information about each program 4 (Easy)
Step-by-step application instructions	Step-by-step application instructions 1 (Hard)	Step-by-step application instructions 2	Step-by-step application instructions 3	Step-by-step application instructions 4 (Easy)
Frequently Asked Questions	Frequently Asked Questions 1 (Hard)	Frequently Asked Questions 2	Frequently Asked Questions 3	Frequently Asked Questions 4 (Easy)
Printable application forms	Printable application forms 1 (Hard)	Printable application forms 2	Printable application forms 3	Printable application forms 4 (Easy)
Division phone numbers	Division phone numbers 1 (Hard)	Division phone numbers 2	Division phone numbers 3	Division phone numbers 4 (Easy)
Access to online forms and claims information (for workers, employers, and/or healthcare providers)	Access to online forms and claims information (for workers, employers, and/or healthcare providers) 1 (Hard)	Access to online forms and claims information (for workers, employers, and/or healthcare providers) 2	Access to online forms and claims information (for workers, employers, and/or healthcare providers) 3	Access to online forms and claims information (for workers, employers, and/or healthcare providers) 4 (Easy)

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* 6. Please tell us how important the following 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

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* 7. Choose the role that applies to you:

NJ Department of Labor employee

NJ worker (claimant)

Employer

Healthcare provider

NJ State employee (other than Department of Labor)

Other (please specify)

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* 8. Please describe what you liked best about the new Temporary Disability and Family Leave Insurance website.

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* 9. Please describe anything else you would like to see on the Temporary Disability and Family Leave Insurance website.

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* 10. (Optional) Please provide your contact information so we can follow up on your responses if needed.

Name

Email address