Partnership Enquiry

Are you filling this out as:

Individual

Business

About your business/company:

Type in your Business/Company Name above.

Pick your companies size above.

Pick your companies industry above.

What role do you foresee Neuphoria playing in your life?

Tick all boxes that apply to you:

I want to qualify Neuphoria technology for use within my business.

I would like to undertake a study using Neuphoria.

I am interested in becoming a distribution partner for Neuphoria.

I would like to become content providers for the Neuphoria platform.

I want to trial the device as individuals or for a small group.

I am interested in becoming a reseller of Neuphoria products.

Other (please specify below)

What role do you foresee Neuphoria technology playing in your company?

Tick all boxes that apply to your business:

We want to qualify Neuphoria technology for use within our company.

We would like to undertake a study using Neuphoria.

We are interested in becoming a distribution partner for Neuphoria.

We would like to become content providers for the Neuphoria platform.

We want to trial the device as individuals or for a small group.

We are interested in becoming a reseller of Neuphoria products.

Other (please specify)

If interested in a study or partnership, what specific objectives are you hoping to achieve using

Neuphoria’s technology?

What timeline are you considering for implementing or collaborating with Neuphoria?

What budget range are you considering for this collaboration?

Please share any additional information or questions you have: