Simply Neuroscience Focus Group #6
Please complete this form to participate in our 6th Focus Group session held by the Neuroscience and Society department at Simply Neuroscience.

These sessions will be 1-hour long Zoom calls in which students/individuals around the world will have the platform to express their thoughts about neuro-related or healthcare policy matters in their area. We plan to begin with a speaker, then move on to open forum discussion if time allows. This will inform future focus sessions or community outreach.

Date: 12 PM ET/9 AM PT on Saturday, January 15th

Guest Speaker: Stuti Chakraborty

Stuti Chakraborty recently completed her undergraduate degree and is currently working as an  Occupational Therapist at Christian Medical College, Vellore. Her contributions to the field of  healthcare are specifically centered around research, raising awareness, communication and advocacy. She was selected as one of the 3 young persons on behalf of the United Nations Major Group for Children and Youth to represent India at the Global Conference on Primary Healthcare, organized by the WHO and Ministry of Health of Kazakhstan, in 2018. She has represented her country at various occasions in the past, was one of the few people selected from India to attend the Harvard Medical School and MIT Healthcare Innovation bootcamp in 2019, and is also currently a Harvard Public Health Review fellow for the 2021 cohort. Her major areas of work include: raising awareness about the impact of disability on marginalized communities, young people and women. In the past, she has been an active contributing member of various youth-focused/youth-led organizations such as the Global Healthcare Workforce Network Youth Hub and Your Commonwealth.  

Only individuals ages 13 and older may register to attend.

If you have any questions or concerns, feel free to DM us at @simplyneuroscience on Instagram or email katherine@simplyneuroscience.org for more information.
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First Name *
Last Name *
Age *
Email *
If you are under the age of 18 years, do you have parental consent to participate in Simply Neuroscience's Focus Group Session? *
If you are under the age of 18 years, please have your parent write out their full name below to verify their acknowledgment of consent. This will serve as an electronic statement.
Please acknowledge the following statement: I am voluntarily signing up for the Simply Neuroscience Focus Group Session and am welcome to withdraw at any point without penalty if I wish. The Focus Group Session and Simply Neuroscience are solely providing a platform for discussion and cannot be held responsible for any possible damages. *
Please acknowledge the following statement: The team may take photographs or record video of some of the virtual events that will be hosted through the Focus Group session; in these instances, a verbal disclaimer will be given in advance stating that a photo or video is about to be capture.  I understand that if I do not wish for my face or voice to be captured in these photos/videos, I must turn off my camera and mute myself. *
Grade (2020-21 School Year) *
Location (City, State, Country) *
e.g. San Francisco, California, USA
Are there any specific topics you would like to discuss/cover as a group during the session? *
Do you have any questions for the speakers?
How did you hear about the SN Focus Groups?
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