Campus Wellness Interest Form

Please complete this form if you are interested in collaborating with HabitHalo on a Campus Wellness project. We will contact you within the next five business days to learn more about your idea and how we might work together.

Sample Projects include:

Identifying behavioral patterns related to relapse risk
Enhancing the precision of cessation interventions
Training AI models for personalized habit support
Informing future grant submissions or publications

How it Works

We rent Qualified Study Partners up to 30 RipLok devices (locking vape cases ) at no charge for 90 days. After the 90 days, you will return the devices to us. If you aren’t able to return a device or your study participant wants to keep it, you’ll owe us $60.

The RipLok iOS App that control the device is downloaded by each of your study participants onto their own phones. They pay $4.99 per month for the app – a total of $14.97 for 90 days. The participant can cancel their app subscription at any time.

Your Organization Information

Your Organization's Name

Company Type

University Wellness Center
Sorority
Fraternity
Other Campus Organization

Your Name

First

Last

Your Job Title

Your Email

Your Phone Number

Name Title Your

Your Organization's Mailing Address

Address Line 1

City

State

Zip Code

Type of Program

Tell Us More!

Program Location (City & State, or Distributed)

Anticiapted Number of Participants

Program Start Date

Funding Status

Fully Funded
In Process for Funding
Not Funded

Your Signature

Clear Signature

Signature Date