Form - Industry › Transmit us your demand

Name*:

Surname*:

Your company name*:

Your position* :

Email *:

Phone number:

Partners inside Sainte-Justine UHC :

External partners:

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:

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*:

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Form - Industry

Transmit us your demand

Target definition

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