Thank you for your interest in participating in a one-on-one feedback session with Intopia Connect.

To help us find the right participants for this opportunity, please answer the following questions. It should only take 5-10 minutes.

Your responses will be kept private and used only for selecting participants for this study.

All fields are mandatory unless marked (Optional).

If you have any questions or need assistance completing this form, please email recruitment.connect@intopia.digital.

Your contact details
First name (required)
Last name (required)
Email (required)
Have you registered as a participant with Intopia Connect? (required)
Phone number (required)

Your personal details
I identify my gender as: (required)
Pronouns (optional)
Year of birth (YYYY) (required)
State or region (required)
Postcode (required)

Your experience managing your health and wellbeing
Do you currently have private health insurance? (required)
Who is your private health insurance provider? (required)
This information will help us ensure we gather feedback from a diverse range of health insurance customers.
How do you currently manage your healthcare appointments? (Select all that apply) (required)
Have you tried out a new health or wellness activity in the last six months? (required)
A new health or wellness activity might include mindfulness meditation, a yoga class, or learning to cook healthy recipes.
Did you use any digital products or devices to help you keep track? (Select all that apply) (required)
Which of the following best describes your current experience managing your health and wellbeing? (Select all that apply) (required)
Please share any further comments on your experience managing your health and wellbeing (optional) (optional)

Disability
Do you have a disability, impairment or chronic condition? (required)
Please select the disabilities and conditions that best match your experience (required)
Sensory disability (required)
Physical disability (required)
Intellectual impairment or cognitive disability (required)
Neurodivergent (required)
Mental or psychosocial disability (required)
Chronic condition or illness (required)

Session requirements
What device will you be using to join the online session? (required)
Do you have experience using Microsoft Teams? (required)
Please describe any accommodations you need to participate in the online session (optional). (optional)

Before you go...
Would you like to be contacted about paid opportunities to provide feedback on specific websites and apps? (required)
How did you find out about this opportunity? (Optional)