Website Survey for Community Partners

Take this brief survey and be entered for a chance to win a free iPod!

Your survey responses will not be matched with your contact information in any way.

Survey Deadline: Friday, November 14


A red asterisk (*) indicates required questions.

Is this your first visit to L.A. Care’s Website?
Yes
No


How often do you visit L.A. Care's Website?
This is my first visit
1-3 times a month
4-6 times a month
More than 6 times a month


Why do you visit L.A. Care's Website? Select up to 3 choices.
Information for Health Insurance Applicant
Overview of L.A. Care Health Plan
News Updates
Register for Events
Grant Initiative Information
Health Education
Learn about our Product Lines
Learn how to get involved with L.A. Care
This is my first visit
Other


What is the best feature of L.A. Care's new Website?
Prospective Member Section
Search Box
Printer-Friendly Format
RSS News Feed
Grantmaking Section


Now that you've seen L.A. Care's new Website, how likely are you to return?
Highly Likely
Somewhat Likely
Not at all Likely


Fill out the form below to be entered for a chance to win a free iPod! Your survey responses will not be matched with your contact information in any way.

Name:*


Job Title:*


Organization Name:*


E-mail Address:*


Phone Number:


Organization Address (include address, city, state & zip code):*


Select YES if you would like to receive occasional news updates from L.A. Care via e-mail.*
Yes
No