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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

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Form - Industry

Transmit us your demand

Mandatory fields are marked with a *.

Identification

Name*:

Surname*:

Your company name*:

Your position* :

Email *:

Phone number:

Partners inside Sainte-Justine UHC :

External partners:

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 solution / suggested innovation*:

Target definition

:

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?* :

Technologies that will be used*:

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

yesno

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:

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 informations given in this form will be accessible to the UTITAC committee only. Should we need to transmit the information to other parties, you would be advise prior to do so.

About this page
Updated on 6/8/2015
Created on 6/4/2015
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