Subject Nomination

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Subject Nomination

How might we rapidly inform and empower communities around the world to stay safe and healthy during and after the COVID-19 outbreak?

Focus Area : Mental Wellbeing
Focus Group : Young Professionals

This requires a subject to spare ~1-3 hour(s) of conversation where you talk to one of our Social Impact Associates (volunteer) around your experiences and their relevance to holistic mental health and wellbeing.

Please read the declarations (at the end of the document) carefully before submission.

You can also nominate yourself as a Social Impact Associate via the following form:
https://forms.gle/LMRw218wSMMAV3sa9

Thanks a lot for your time!

Cheers!
Shwetabh S Verma

Email *

First Name *

Middle Name

Last Name *

Age *

Gender *

Male

Female

Other:

Email Id *

This is where you get invitation to the meeting with our researcher.

Number *

Please put in your complete phone number with country code.

City [Current] *

Country [Current] *

City [City of residence if your country of citizenship] *

Country [Citizenship] *

I was invited by : *

Write the full name of the person who invited you for the conversation.

Time Zone *

Declaration *

Please select the declaration

I do hereby, under no influence or pressure, choose to volunteer for a conversation around Mental Health and Mental Wellbeing which would be used for research purpose and eventually towards discovering and solving issues around mental health and mental wellbeing.

Declaration *

Please select the declaration

I understand that this is not a counselling or therapy session. I confirm that I'm not suffering from any mental health issues at the moment and I'm mentally and emotionally stable to share my experiences and have a conversation around the topics pertaining to mental health. I understand that it's MY duty and responsibility to communicate to the researcher in case I feel triggered at any point during our conversation and seek help at the earliest to take care of my mental health.

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