AI 4 Hospitals – Expression of Interest

This form allows you to express your interest in joining the AI 4 Hospitals community.

AI 4 Hospitals is a Brussels-based non-profit initiative focused on practical, responsible, and real-world adoption of Artificial Intelligence in hospitals.

The information collected through this form will be used solely to manage the community.

Sign in to Google to save your progress. Learn more
Full name *
  Full name  
  Email address   *
  Professional email address  
  Organisation / Institution   *
  Hospital, organisation, institution, or company (if applicable)  
Role / Profile   *
  Areas of interest   *
Required
  Motivation   
What is your main interest in joining the AI 4 Hospitals community?
(Optional)
Data protection notice Sans titre

The information collected will be used exclusively for the purpose of managing the AI 4 Hospitals community.

Your personal data will not be shared with third parties and will be handled in accordance with applicable data protection regulations.

Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report