Osin Starter Expression of Interest Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

What's your phone number?* This field is required.Country code (+64) is not required

5

Where are you located?* This field is required.

Auckland

Wellington

Christchurch

Other

6

Which company do you work for?

7

What's your position?

8

Do you work at least four days a week from the office?* This field is required.Do not include days you work from home.

YESNO

9

Do you spend 80% of more of your working hours inside the office?* This field is required.

YESNO

10

Select the option that best describes your working environment?* This field is required.

My desk is near a window

My desk is more than 3 meters from a window

My desk is in a room with no windows

11

Do you currently pay for any health or wellness-related subscriptions?Select all that apply

None

Gym membership

Supplement subscription

Digital subscription (Fitbit Premium, Apple Fitness +)

Other

12

Do you do shiftwork as part of your professional role?* This field is required.Shiftwork is defined as working for more than one hour between 7:00 pm - 6:00 am

YESNO

13

If selected, do you agree to share your experience with Loop?* This field is required.This will involve a phone call with a member of our team during the trial, and possibly writing a review for our website or giving an on-camera testimonial at the end of your experience.

YESNO