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Health Tech Collective Application Form
A holistic accelerator program for entrepreneurs who want to build a million-dollar HealthTech business without burning out
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Email
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Your email
Testimonials:
Chris Pallatroni
Will Moore
Will Glass
Zein Fayyad
Full Name
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Your answer
Email Address
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Your answer
What business stage are you in?
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Not yet launched
Recently launched (within the last 6 months)
Launched more than 6 months ago
What are you building? Short description of your business.
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Your answer
What are your business and lifestyle goals for the next 12 months?
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Your answer
Which things/traits/circumstances do you feel are holding you back right now?
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Your answer
What tools, techniques & strategies have you explored so far to deal with that challenge and how did those work for you?
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Your answer
On a scale of 1-10 (1 = not ready to change current circumstances; 10 = I'll do whatever it takes!!!!!) how motivated are you to get to the next level? What motivates you?
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Your answer
On a scale of 1 -10 how stressed do you feel right now? What are your key stressors?
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Your answer
What are you looking for in an accelerator program? Choose all that are relevant.
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Identifying my blind spots
Identifying my next action steps
Understanding how to motivate myself & change unsupportive beliefs & behavior
Improving my work-life-balance
Being held accountable for my goals
Being part of a supportive community of like-minded entrepreneurs
Getting honest and direct feedback
Continous learning & improving my skillset
Getting access to resources, experts & personal intros to key players who can open doors for you
Getting tailored 1:1 support
Other
If you join this program - what would have to happen in your life and business as a result of joining this program to make this the best investment you've ever made?
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Your answer
Do you have the means to invest in this program right now (USD 10k one-time payment or USD 3.4k/month for 3 months)?
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Yes
No
How did you find out about the HealthTech Collective? If someone referred you, please provide their name & email address.
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Your answer
I want to build the best possible community to help every member thrive - so let's hop on a call to get to know each other, see if you're a good fit, and answer all the questions you might have. :)
Please book a call
here
.
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Done!
A copy of your responses will be emailed to the address you provided.
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