Embodifi Contact Form

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Thank you for getting this far - your interest is greatly appreciated.

We, Embodifi, are currently working on a Creative Outlet product for Autistic Individuals of ranging verbal abilities to safely and easily express their thoughts, feelings and emotions.

By completing this Contact Form, you are expressing your interest to participate in an informal interview (20 - 30 minutes in length).

I will send you an email (email will come from matthew.falcomata@gmail.com) within 1 day of completion to arrange a time and method of interview that's convenient for you.

I'm super excited about Embodifi and I cannot wait to speak with you!

I am a (select all that apply): *

Parent of an Autistic Person/s

Caregiver to an Autistic Person/s

Other:

Required

Name *

Email Address *

Contact Number

Country of residence

City of residence

Please indicate your general availability for an interview, including days of week and times of day or night *

Please indicate your preferred method of interview *

Virtual call

In person

Phone call

Is there anything we can do to accommodate your needs or provide a more supportive environment?

Submit

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