Diagnostics Growth Hub
Expression of Interest Form
Sign in to Google to save your progress. Learn more
Email *
Company *
Website
Registered Address
No. Employees *
What is your current funding status? If you are receiving funding, please outline the source and value below *
Please provide a brief outline of your product/technology and what it does. *
Type of Diagnostic Product *
Therapeutic areas/ Disease areas involved *
What Therapeutic/Disease areas would you like to be involved in?
What stage is your product at? *
Who are/what is your target market? *
What is your target market size? *
What technical proof of concept have you demonstrated, and do you need support to generate further data? *
What do you view as your competitive advantage? (please list as many as you like) *
Please outline your core team and their respective roles *
Do you have any existing collaborations? *
If Yes to Collaborations, please outline whom with below. *
In what areas do you require support? *
Yes
Not sure
No
Funding/Investment
R&D
Clinical Trials
Manufacturing
Market Access
Regulatory
Reimbursement
Marketing
Logistics
Space (Lab/Office)
If there is a specific sub-area of the above categories, please outline below e.g grant applications *
Please provide below any links to research publications and articles regarding your company and/or technology
Any other comments
How did you find out about the Diagnostics Growth hub? *
If other or via a specific partner/contact please outline below *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms