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* 1. ACIITC is developing a mentoring program to leverage the knowledge of experts within the aged care sector and increase the uptake of innovative technologies. Are you interested in being:

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* 2. Which areas of aged care would benefit most from a mentoring scheme? (Tick as many areas as appropriate)

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* 3. What sort of mentoring would be most effective?

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* 4. How frequently should mentors and mentees have contact?

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* 5. If you are interested in being a mentor, how much time could you devote per month?

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* 6. If you are interested in being a mentee, how much time could you devote per month?

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* 7. Any other comments you might like to make?

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* 8. Your name and email address.

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