Français

CHU Sainte-Justine

Mother and child university hospital center

Hospital & care Learning centre Research Rehabilitation Health Promotion Foundation

CHU Sainte-Justine

Mother and child university hospital center

Search for:

Home
About us
Visits & Hospital Stays
Care & Services
Calendar & Press room
Health Care Professionals

About us > Innovation > Innovation Platform > Forms > Employees

Employees
Industry

Form - Employees

Transmit us your demand

Mandatory fields are marked with a *

Identification

Name*:

Surname*:

You are*:

Researcher
Doctor
Healthcare Professional
Administrator
Other

Department*:

Immediate superior*:

Name of the person that approved this demand*:

Email*:

Phone number:

Partners inside Sainte-Justine UHC:

Partners outside Sainte-Justine UHC:

Project

Where is your innovation in the steps below*:

Needs assessment
Definition of the targeted public
Definition of the protocol, prototype
Redaction of collaboration agreements
Research and development, adaptation
Implementation in Sainte-Justine UHC
Impacts analysis
Valorisation, commercialisation

Description of the need / problem*:

Description of the solution / suggested innovation*:

Target definition

:

How many patients will be touched by this innovation?:

What type of clientele?:

How many families will be touched by this innovation?:

How many employees, by categories, will be touched by this innovation?:

Timeframe contemplated for the next steps

:

What resources (human, financial and material) do you have for your project?*:

What resources (human, financial and material) do you still need to acquire for your project?* :

Person that approved this budget?*:

Technologies that will be used*:

Competition assessment/
Do you know any other similar products being done elsewhere or in another format?:

yesno

Impact assessment/
What are the possible fallout for Sainte-Justine UHC (in terms of finance, visibility, publications, quality of care, etc.)?:

Risk related to the project:

Legal or clinical procedures are needed?*:

yesno

Information Technology /
What are your needs? Please explain briefly the system being created if related to informatics technology:

Does your solution impact on the current system?*:

yesno

How do you plan to implement your innovation in the UHC (strategy, training plan, steps of deployment, etc.)?:

Demand

Expected delay for this demand*:

Please explain your expectations regarding the innovation platform?*:

Would you be available to meet the coordinator of the platform to give details about your project?*:

yesno

Do you have any other comments or questions you would like to address?:

Security Code*:

Enter security code:

Security code

Please note...

The submission of the form does not engender automatically a help of the platform. The project has to be approves by the executive committee of the UTITAC.

About this page
Updated on 6/4/2015
Created on 6/4/2015
Alert or send a suggestion

Every dollar counts!

Thank you for your generosity.

It is thanks to donors such as you that we are able to accelerate research discoveries, to heal more children every year and to continue to offer world-class care.

It is also possible to give by mail or by calling toll-free

1-888-235-DONS (3667)

Contact Us

514 345-4931

Contact, access map
Visiting hours

Legal

© 2006-2014 CHU Sainte-Justine.
All rights reserved.
Terms of Use, Confidentiality, Security

Warning

All information contained within the CHU Sainte-Justine site should not be used as a substitute for the advice of a duly qualified and authorized medical practitioner or any other health professional. The information provided on this site is intended for educational and informational purposes only.

Consult your physician if you feel ill or call 911 for any medical emergency.