JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Apply for AI in Health 2024
Application DEADLINE is Sunday, September 17th
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
'AI for Health' Partners
Organisation Name / Company Name:
Your answer
Name
*
Your answer
Job Title?
Your answer
Phone Number
*
Your answer
Company Location:
Your answer
Number of employees (including you):
1
2-10
11 - 49
Over 50
Are you a? (please tick boxes)
Business or Technology Provider
Researcher / Academic
Healthcare company
AI specialist
Other:
On a scale of 1-5, how would you rate your current knowledge of Artificial Intelligence?. (1 = very little/limited knowledge- 5 = very knowledgeable
1
2
3
4
5
Clear selection
Business or Health Innovation AI Proposition - please give your main reason to attend the programme
Healthcare Market Knowledge
Education on AI
Mentoring for your Idea
Access to Resources
Other:
Clear selection
Do you have a potential AI Solution or Healthcare need that could be solved using AI ?
Yes
No
Don't know yet
If you have ticked yes above, can you describe your proposed AI solution, or the potential Challenge that you think can be improved by AI (max. 300 words):
Your answer
What is your innovation stage?
Too early to say
Idea
Prototype
User trials
Paying customers
Other
Clear selection
What is your biggest challenge for the next 6 months?
Understanding the Market Opportunities
Understanding the Technology
Access to Skills and Resources
Funding
Training
Access to AI specialist consultants
Clear selection
Do you have access to technical resources for the project
Yes, I have my own AI team
Yes, I have access via partners
I need help to understand what technical resources are required
By checking this box I agree to DkIT
Privacy Policy
and
Data Protection Policy
, and to share my data with DkIT's partners supporting the programme for the purposes of the programme. Agreement to these terms is required in order to process your application.
*
YES
Required
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
