At-Home Caregiver Research Interest Form

We are working on research to explore a digital application’s effectiveness in supporting at-home caregivers. This research will help identify what caregivers are currently utilizing to support their everyday responsibilities, what other features they need access to and what's currently missing.

Please fill out the information below to become a potential participant or recommend someone you know!

Research Study Details

Research Type: Interview
Length: 60 minutes
Location: Virtual (Phone/Computer/iPad)
Compensation: There is no compensation for this study

Participant Eligibility

18 years or older
Read, write, and speak English or Spanish
Currently providing (or have previously provided) at-home care for a family member/friend
Lives in the U.S.
Have access to a computer/phone with WIFI
Must consent to audio recordings for note taking purposes

*A caregiver is anyone who has the primary responsibility of providing daily at-home care for someone and does not receive financial compensation for care.

I confirm I or the individual I am recommending for this study, are eligible for this study. *

Yes, I fit the eligibility criteria.

No, I do not fit the eligibility criteria.

No, but I know someone who I can recommend for this study.

Recommended Participants Information

To recommend more than one participant, please fill out the survey a second time after completion.

Your first & last name. *

The first and last name of your recommended participant. *

Recommended participant's email. *

Recommended participant's phone number. *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Almost done!

Would you like to receive updates about Circle Care? *

Yes