Apply For Membership

Membership Application
First Name*
Last Name*
Email*
Phone Number*
Title and Affiliation*
Are you representing?*
- A research project, start-up or small company seeking clinical validation, mentorship or investment
- A large, established company seeking clinical validation services

Membership Application – Start-Up
Membership Application – Corporate
Company Name*
Brief Company Description*
What best describes you?*
- An incorporated HealthTech Start-up
- Clinicians/researchers with an innovation idea
- Students with an innovation idea
- Other
Other
What is your sector?*
- Digital Health / AI
- Wearables/mHealth
- Surgical or Medical Device
- Biotechnology
- Other
Other
Website (if applicable)
What are your needs?*
Who are the founders?*
Number of members (including founders)*
What unmet clinical need are you addressing?*
Pitch your company/innovation in 100 words*
What medical specialty is your unmet need in?*
Check all that apply
- Anesthesia
- Cardiovascular
- Emergency Medicine
- Geriatrics
- Hospital Administration
- Liver and Pancreas
- Neurology
- Obstetrics & Gynecology
- Orthopedics
- Radiology
- Thoracic
- Urology
- Breast
- Colorectal
- ENT
- Hematology
- ICU
- Minimally Invasive Surgery
- Nursing
- Ophthalmology
- Plastic Surgery
- Respirology
- Trauma
- Vascular
- other
Other*
What is your technology's developmental stage?
- TRL 1: Unmet need identified
- TRL 2: Technology concept formulated
- TRL 3: Design finalized
- TRL 4: Prototype validated in a laboratory environment
- TRL 5: Proof-of-Concept in a simulated environment
- TRL 6: Preclinical Evaluation
- TRL 7: Pivotal clinical trial completed
- TRL 8: Multi-centre trials completed
- TRL 9: Technology successfully deployed in a clinical setting
Are you funded?*
- Yes
- No
How much are you funded?*
What are your goals and expectations of the Clinical Innovation Platform?*
What is your expected occupation timeline?
- 6 months
- 12 months
- 18 months
- 24 months
Development stage of the products requiring clinical validation? **
- TRL 1: Unmet need identified
- TRL 2: Technology concept formulated
- TRL 3: Design finalized
- TRL 4: Prototype validated in a laboratory environment
- TRL 5: Proof-of-Concept in a simulated environment
- TRL 6: Preclinical Evaluation
- TRL 7: Pivotal clinical trial completed
- TRL 8: Multi-centre trials completed
- TRL 9: Technology successfully deployed in a clinical setting
What is your timeline?*
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Membership Application

Membership Application – Start-Up

Membership Application – Corporate