Injury Form

UI Elements

A path selector and a short form. Vehicle, personal injury, and workers' comp each ask their own questions. The result stays on the page.

Role
UI + front-end
Stack
React
Focus
Path form
Status
Sample

Injury form (sample)

Which kind of injury?

Case study

Role: UI design + front-end

Context: An injury page that starts with a choice of path. Each path asks a different short set of questions, one step at a time.

The decision

A person should pick the kind of injury first, then answer the current question and move on. The contact fields come after the questions. The result stays on the page.

What I owned
  • The path selector: vehicle, personal injury, and workers' comp.
  • The questions on each path, including the note, ZIP, name, email, and phone.
  • The confirmation. Form data is kept for demonstration purposes only and will not be sold or shared.
How someone else reuses it

A new offer passes a list of paths. Each path is its own list of questions. A choice advances the form. The last step is the result, still on the page.

In React

InjuryForm holds the paths and the steps. Choosing a path or an answer records lead_step. Reaching the result records lead_complete. Form data is kept for demonstration purposes only and will not be sold or shared. The same idea of keeping a path in the browser is the injury evaluation landing page.

Looking for this kind of work on your team?

I build production interfaces in React and Next.js, and the events those pages fire. I can own the frontend. Let's talk.
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Developed with React Developed with Next.js