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WHIS Wellbeing Needs Assessment Form
Thank you for your interest in WHIS — Optimising Wellbeing, Enhancing Performance, and Transforming Communities. This form helps us understand your organisation’s wellbeing priorities, workforce or community needs, and resources so we can design tailored programmes.

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Email *
Section 1: Organisation Information *
1. Organisation Name *
2. Sector / Type of Organisation *
If 'Other' was selected above, please specify your sector/type of organisation:
3. Number of People Served / Employees *
4. Headquarters / Location(s) *
5. Contact Person Name & Role *
6. Email Address *
7. Phone Number *
8. Are you a current WHIS member?
Clear selection
Section 2: Wellbeing Priorities *
1. Which areas of wellbeing are most relevant to your organisation or community? (Select all that apply) *
Required
If 'Other' was selected above, please specify the area(s) of wellbeing:
2. Current wellbeing initiatives / programmes in your organisation (e.g., EAP, gym memberships, internal workshops): *
3. Biggest challenges related to wellbeing in your organisation or community: *
4. How do you currently measure wellbeing outcomes? (Select all that apply) *
Required
If 'Other' was selected above, please specify how you measure wellbeing outcomes:
Section 3: Programme Interest *
1. Which WHIS programmes are you interested in? (Select all that apply) *
Required
If 'Other' was selected above, please specify the programme type:
2. Preferred delivery method: *
3. Preferred programme duration: *
Section 4: Budget & Resources *
1. Approximate annual budget for wellbeing initiatives: *
2. Open to co-designing a programme based on budget and priorities?
Clear selection
3. Other resources or support your organisation can contribute to wellbeing initiatives (e.g., internal communication, dedicated staff time, space):
Section 5: Readiness & Next Steps *
1. Timeline for implementing wellbeing programmes: *
2. Would you like a WHIS consultation to explore tailored solutions? *
I have read and agree to the WHIS Privacy Policy.
 *
3. Any additional comments or information for the WHIS team:
Submit
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This form was created inside of World Health Innovation Summit CIC.

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