This two-minute survey will help us understand your experience of the Connect Well website.

Your feedback is being collected by Clear Horizon Consulting, who are evaluating the website on behalf of Connect Well. Any personal information you provide will be kept confidential and only used for the purpose of evaluation, in accordance with the Australian Privacy Principles.

By completing the survey, you consent for your answers to be collected and used to evaluate the Connect Well website in accordance with these Privacy Principles. To find out more, email

NOTE: This form autosaves the form data that you enter as you progress to ensure you don't accidentally lose your data if the page reloads accidentally etc. IF YOU ARE ON A PUBLIC DEVICE and there is potential that you may not complete the form, you can click the button below and we will not autosave your form data. All form data is cleared after the form is submitted successfully.

Feedback Survey

Submission Successful

Thank you for your submission. We have sent you an email confirmation of your submission details. Please contact us if you do not receive this email.

Submission Details



Submission Date:

If you entered an email address, your submission details have been sent to you in an email.


Save Form Progress