Contact us!
Name *
Your answer
Company name *
Your answer
Product/ Service/ Idea Name *
Your answer
Area of focus *
Website
Your answer
Email *
Your answer
Phone number
Your answer
Short description of the company/product *
Your answer
What is the most innovative aspect of your proposal? *
Your answer
What is the value you estimate this will bring to MSD? *
Your answer
What is the value you estimate this will bring to our patients or Health Care Professionals?
Your answer
What is the potential value for your company?
Your answer
*
We inform you that the data you send us through this electronic form will be included in the information systems of TicBiomed, Information Technologies of the Region of Murcia. Such communication will be used to handle your request, as well as to send you information that may be of interest, regarding our activity. By indicating your data and following the provisions of the Regulation of the European Data Protection 679, you give your explicit consent to TicBiomed, Information Technologies of the Region of Murcia to proceed, in compliance with the purposes mentioned in the previous section, to the processing of the personal data provided. Said data will not be disclosed to third parties and will be processed as long as you do not indicate otherwise. Nonetheless, at any time you can exercise the rights of access, limitation, and deletion through the address: CEEIM, Campus Universitario de Espinardo, 7, Espinardo, 30100 MURCIA or email: lopd@ticbiomed.org
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of TICBioMed.