Patient-owned dataClinical decision supportDisease managementDigital diagnostics & therapiesKnowledge empowermentLeveraging data and digital toolsOthers
Please shortly describe the problem you are solving* (max. 400 characters)
Please describe your solution/approach in one sentence* (max. 400 characters)
Please describe your product/service* (max. 400 characters)
If you have an online demo, please provide the URL
Relevance: Please show clearly how your business model contributes to the digital (r)evolution for patients and outline the potential of how your product or solution will impact the field* (max. 1400 characters)
What is/will be your regional market coverage?*
Who are your customers?*
Estimated number of customers*
Estimated market volume* (Please enter in Euro)
How many people work in your start-up?* 12-56-1010+
In which stage is your company/product today?*
PrototypeBeta testMarket launch & pilot customersNational roll outInternational roll out
Have you incorporated your company?* YesNo
If “Yes”, what is the legal form?
If “Yes”, where was it incorporated?
If “Yes”, when was it incorporated?
Do you have funding?* YesNo
If “Yes”, please give us a rough idea of your level of funding:
Under €50,000€50,000 - €250,000€250,000 - €500,000€500,000 - €1,000,000€1,000,000 - €2,000,000€2,000,000 - €3,000,000 (max.)
If “Yes”, how long is your business plan funded?
Please provide information about investment rounds, valuation and investors that participated in funding (Please enter in Euro)* (max. 400 characters)
Do you already have existing cooperations/collaborations (e.g. research institutes, corporate institutes, governmental institutions, health institutes)?*
If “Yes”, which cooperations/collaborations?
Do you have an advisory board? (e.g. scientific, strategic,…)* YesNo
If “Yes”, please name the members of the board and their function (max. 400 characters)
How has your revenue (in Euro) developed since the start of your company (by year)?* (max. 400 characters)
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Company website URL
Company social URL
Further information (e.g. pitch deck in ppt, pdf) max. 10 MB
For any questions regarding the award or the application, please contact us: firstname.lastname@example.org
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