Application Form

Application Form

Ramsay Santé Accelerator Program
Company Name*
Full Name*

First NameLast Name
Business Title*
Phone Number*
E-mail*
Company Address*

Street Address

Street Address Line 2

CityCountry

Postal Code
Number of Employees*
or size of "Core Team" in number of FTE
Annual Revenue
in €M
Founding Year*
Most Recent Funding Round*
What is the primary pathology for your product and service?*

OrthopedicsCardiologyOncologyPrimary CareMental HealthRadiologyRehabElderly CareGeriatricsOther
What is the primary focus of your product and service?*

Remote MonitoringPrevention / Customer & Patient EngagementPatient Centered CareOut of Hospital / Remote CareImprovements benefitting doctors, nurses and other staffStaff Efficiency / Reduce staff shortageNLP, AI, ML, RPA solutionsOther
In which of the following markets are you active?*

FranceSwedenNorwayDenmarkItalyGermanySpainUKEUUSARest of world
What customer segments do you serve?*
e.g. Patient Groups, B2B, B2C, B2B2C
What problem or need does your service and(or) product solve?*
Healthcare Provider Need; Patient Related Need
What patients (groups) does the solution target?
How many customer and(or) patients do you have in total?
Does your product have a Medical Device Class certification?*

YesNoWork In Progress
If Yes - What Medical Device Class Certification ?
e.g. Medical Device Regulation Classification and CE-marking; FDA Class I, Class II, and Class III.
Company Presentation*

PDF, Powerpoint, Keynote - no more than 10 pages
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Video Presentation*

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The video pitch is intended to give us a more personal, dynamic and engaging presentation of you, your company and your service(s) and product(s).

Please include the following information in the video presentation (some of which you may have already written in the application form):
- Describe the solution(s) and product(s)
- What does it do?
- Why is that of value to the users / target group?
Please keep the videopitch under 3 minutes in duration.
Any Special Comments?
Release of Information Clause*
Personal Data*
Should be Empty: