Thank you for your interest in participating in a user 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.

Have you registered as a participant with Intopia Connect? (required)

Your contact details
First name (required)
Last name (required)
Email (required)
Phone number (required)

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

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)

Technology usage
Do you have access to a laptop or desktop computer that you can use for this user feedback opportunity? (required)
Which of the following do you use as your primary screen magnifier with your laptop or desktop computer? (required)
Do you use any other types of assistive technologies when using your laptop or desktop computer? (required)
Please list the other assistive technologies you use with your laptop or desktop computer. (required)
How long have you been using your current assistive technology? (required)
Please read through the statements below and choose the one that best matches your experience using assistive technology. (required)

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)