Digital Wellness App Experiment Consent Form
Please review the information below and provide your consent to participate in the digital wellness app experiment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age Group
*
Please Select
Under 18
18-24
25-34
35-44
45-54
55+
What type of device will you use for the experiment?
*
Smartphone (iOS)
Smartphone (Android)
Tablet
Other
Signature (Please sign below to confirm your consent)
*
Submit Consent
Submit Consent
Should be Empty: