MassMEDIC IGNITE SUBMISSION FORM
We're looking for some great start up companies to work with in 2019. Please fill out the below information about your company and we will get back to you shortly. Please note, the deadline is April 26, 2019 at 9AM.
Email address *
First Name *
Your answer
Last Name
Your answer
Company Name *
Your answer
Where is your company based?
Your answer
Please provide a short description of the problem your seeking to address in the healthcare system? *
Your answer
Have you built a prototype of your device?
How many employees do you have currently? *
Your answer
What level of funding have you raised? *
Are you currently working with an accelerator or other incubation program? *
If you answered yes to the above question, which accelerator or incubator?
Your answer
What are your biggest challenges? Check all that apply. *
Required
Please provide your education (degrees and institutions) *
Your answer
How long have you worked in medtech? *
Your answer
What companies have you worked for in medtech? *
Your answer
If you are new to medtech, what field have you worked in previously? *
Your answer
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