Video Story Expression of Interest Form

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Please be aware that LifeTec is no longer providing a dedicated assistive technology equipment display or SMART home demonstrator.

For more information contact 1300 543 383

Our services can be provided at LifeTec or we can come to you.

Brisbane
Shop 202, Newmarket Village
400 Newmarket Road
Po Box 3241
NEWMARKET QLD 4051

Office: 8.30am- 4.30pm

Townsville
Shop G-3A, Domain Central
103 Duckworth Street
Po Box 8280
TOWNSVILLE QLD 4814

Display Centre: 8.30am- 4.30pm

Home » Video Story EOI Form

Name
First Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you an? (Please mark the box)
- Assistive Technology (AT) User
- Family Member
- Carer
What type of AT do you use?
Video story project:
Please mark the box if you are interested in being part of the video story project.