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Help us improve

Your feedback will help improve our online services. Please take 5 minutes to tell us about your experience using our web site today.

If you have a specific issue or question and need a response, please contact us instead.

1. When visiting the L&I website today, what is your role? *This question is required.

How many people work for your company? *This question is required.

Are you currently unable to work due to your injury?

2. What was the purpose of your visit to the L&I website today? *This question is required.

Which of these tasks did you primarily come here to do today? *This question is required.

3. Were you able to accomplish your primary task? *This question is required.

Please explain.

4. What are you using to access the L&I website today? *This question is required.

Please enter an 'other' value for this selection.

5. How often do you visit the L&I website? *This question is required.

6. What is your overall satisfaction with the L&I website? *This question is required.

	1	2	3	4	5	6	7	8	9	10
Very dissatisfied	1	2	3	4	5	6	7	8	9	10	Very satisfied

7. How likely are you to speak positively about the L&I website to colleagues, friends, or acquaintances? *This question is required.

	0	1	2	3	4	5	6	7	8	9	10
Not at all likely	0	1	2	3	4	5	6	7	8	9	10	Extremely likely

8. How can the L&I website better meet your needs?

9. May we contact you for additional feedback that will help us improve our website?

Please let us know how to contact you:

First Name

Last Name

Email Address

Phone Number 555-555-5555