Galien MedStartUp Program Registration Form

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COMPANY
Company Name :
Date of incorporation :
Number of Employees
Industry sectors
Therapeuthic areas:
CONTACT INFO
First Name :
Last Name :
Job Title :
Email :
Phone Number :
Corporate website :
YOUR SOLUTION
Description of your company - The one-sentence pitch:

Please, answer in ONLY ONE SENTENCE

Description of your innovative solution - Technology & Product :

Please, answer in MAXIMUM 50 WORDS

Which problem are you solving ?

Please, answer in MAXIMUM 50 WORDS

Target market segments :

Please, list your 4 MAJOR MARKET SEGMENTS (Market segment 1 / Market segment 2 / Market segment 3 /Market segment 4 )

Competition :

Please, list your 4 MAJOR COMPETITORS OR ALTERNATIVE SOLUTIONS (competitor 1 / competitor 2 / competitor 3 / competitor 4 )

Your key value proposition :

Please, list your 4 KEY ADVANTAGES (Advantage 1 / Advantage 2 / Advantage 3 / Advantage 4 )

What kind of collaborations are you looking for ?

Please, list your 4 MAJOR TARGET PARTNERS (Target partner 1 / Target partner 2 / Target partner 3 / Target partner 4 )

YOUR DEVELOPMEMENT IN THE US MARKET
Intellectual Property Rights in the US ?
FDA Accreditation ?
Are you already in the North-American market ? If yes, how ?
If yes, how ?
MEDSTARTUP BOOTCAMP - OCT. 25
Would you be interested in meeting with the following party ?
Regulatory expert | 1-on-1 Bootcamp
How do you categorize the funding raised to date?
Investors | 1-on-1 Bootcamp
Immigration | 1-on-1 Bootcamp
Subsidiary’s needs | 1-on-1 Bootcamp
Recruitement | 1-on-1 Bootcamp
Communication expert | 1-on-1 Bootcamp
IMPROVE YOUR VISIBILITY
Would you like to pitch your innovation during the MedstartUp days ?

(20 companies would be selected to pitch)

Would you like to have a short video teaser during the MedstartUp days ?
CONTACT INFO