(Archive) Investor Ecosystem Questionnaire

(Archive) Investor Ecosystem Questionnaire
Account ID
Type of Investor for Form
Calculated Form Title
General Information
Company Name*
Preferred Contact*

First NameLast Name
Preferred Contact Email*
example@phazemos.com
Invoicing Contact*

First NameLast Name
Invoicing Contact Email*
example@example.com
Website URL*
Please confirm that you are an accredited investor*

Yes

Investor Information
What type of investor are you?*

Bank fundBusiness angelCorporate investorFoundationInstitutional investorLeasingPrivate investor / family officePublic fundVenture capital fundOther
If you selected "other" above, please describe your investor type below.
What are the key geographies your firm is focused on?

AllAPACEuropeM. East & AfricaNorth AmericaSouth AmericaUKOther (list below)
If you selected "other" above, please describe your key focus geographies below.
What is the average ticket value for investment? (in millions)*
What is your revenue target for these acquisitions? (in millions)*
What industries are within your investment criteria?*

AIBiotechDiagnosticHealthtechLife Science R&D Service Companies (CROs, CDMOs, Consultancies etc.)Life Science Technology CompaniesMedical DevicePharmaOther
If you selected "other" above, please describe the additional industries below.
What is your therapeutic focus? Select as many as you like*

AgnosticAdrenalAestheticsAnti-infectivesAMRAutoImmuneCardiologyCardiovascularCNSContraceptionDermatologyDiabetesEndocrinologyGastroenterologyGeneticsGIGynaecologyHematologyHepatologyImmunologyImmuno-oncologyInfectious DiseaseInflammationMen's HealthMetabologyMusculoskeletalNASHNephrologyNeurologyNeuromuscularNeuro-oncologyNutritionObesityOncologyOphthalmologyOrthopedicsPainPediatricsPhysiologyProbioticPulmonologyRare Blood DiseaseRare DiseaseRenalRespiratoryRheumatologySexual HealthUrologyVascular DiseaseVirologyWomen's HealthWound CareOther
If you selected "other" above, please describe the additional therapeutic focuses below.
Do you require the investment opportunities to be in a certain geography? Select as many as you like*

GlobalNorth AmericaEuropeAsiaMiddle EastAfricaOther
If you selected other in the question above, please list the specific countries below:
What is your preferred phase in development? Select as many as you like*

DiscoveryPre-ClinicalPre-INDPhase 1Phase 2Phase 3Post-Market
Do you prefer particular modalities? Select as many as you like*

Antibody-Drug ConjugatesSmall MoleculeBiologicsGene TherapyCell TherapymABsPeptidesPsychedelicsOther
If you selected "other" above, please describe the additional modalities below.
What stage do you invest? Select as many as you like*

Pre-SeedSeedSeries ASeries BSeries CPost-IPOOther
If you selected "other" above, please describe the additional stages below.
Are you open to repurposed therapeutics?*

YesNo
Are you open to combination therapeutics?*

YesNo
Do you prefer to invest in platform technologies?*

YesNo
Do you lead investment rounds?*

YesNo
What types of companies do you look to target for your portfolio? (check all that apply)*

Biotechnology - OtherBiotechnology - R&D ServicesBiotechnology - Therapeutics and DiagnosticsDigital HealthInvestorMediaMedical TechnologyPharma (fully integrated)Professional Services and ConsultingPublic / Non-Profit Organizations / Medical FacilitiesSupplier & Engineering
(Biotechnology - Other) Select your business area (check all that apply)

AgBioCosmeticsEnvironmentalFoodIndustrial BiotechnologyNutraceuticalsVeterinaryOther
(Biotechnology - R&D Services) Select your service area (check all that apply)

Analytical servicesBiochipsBioelectronicsBioinformaticsCell cultureCMO (Contract Manufacturing Organization)CRO (Contract Research Organization)Diagnostic instrumentationDiagnostic servicesDrug deliveryFill & finishGenomicsProteomicsScreeningSynthesis servicesOther
(Biotechnology - Therapeutics and Diagnostics) Select your business areas of interest (check all that apply)

AntibodiesAntibody-drug-conjugateAnti-infectivesBiosimilarsCell therapyDrug deliveryGene therapyGenericsImmunotherapyMicrobiomeMolecular diagnosticsNatural CompoundsNucleic acid drugsPeptidesProteinsSmall moleculesStem cellsVaccinesOther
(Digital Health) Select your service area(s) Select your business areas of interest (check all that apply)

Artificial intelligence (AI)Doctor NetworksElectronic Medical Record / Electronic Health RecordHealth & Wellness (IoT)Health Services SearchHealthcare Mobile CommunicationMedical Big Data & analyticsMobile Fitness / Health AppsOnline Health CommunitiesPatient EngagementPayments & InsurancePopulation Health ManagementPredictive AnalyticsRemote MonitoringTelehealthOther
(Investor) Select your service area(s) Select your business areas of interest (check all that apply)

Bank fundBusiness angelCorporate investorFoundationInstitutional investorLeasingPrivate investor / family officePublic fundVenture capital fundOther
(Media) Select your service area(s) Select your business areas of interest (check all that apply)

News agencyNewspaperOnline publicationTrade pressTV & RadioOther
(Medical Technology) Select your business areas of interest (check all that apply)

Active implantable devicesAnaesthetic and respiratory devicesBiomaterialsCoatingsDelivery devicesDental devicesDiagnostic and therapeutic radiation devicesDiagnostic devicesElectro mechanical medical devicesHospital hardwareImagingNon-active implantable devicesOphthalmic and optical devicesRegenerative MedicineReusable instrumentsSingle use devicesTechnical aids for disabled personsWound careOther
(Pharma (fully integrated)) Select your business areas of interest (check all that apply)

AntibodiesAntibody-drug-conjugateBiosimilarsCell therapyDrug deliveryGene therapyGenericsImmunotherapyMicrobiomeMolecular diagnosticsNatural CompoundsNucleic acid drugsPeptidesProteinsSmall molecule therapeuticsStem cellsVaccinesAnti-infectivesOther
(Professional Services and Consulting) Select your business areas of interest (check all that apply)

Business developmentCommunication & PR/IRDeal arrangerDrug development consultingDue diligenceEvent organizationFinancial servicesHuman resources servicesInformation providerIT servicesLegal servicesManagement consultingMarket accessMarket researchOperations/Health & safety/PurchasingPatents & TrademarksProperty management/Real estateRegulatory AffairsReimbursement & PricingSales & MarketingTechnology transferTranslation servicesValuationOther
(Public / Non-Profit Organizations / Medical Facilities) Select your business areas of interest (check all that apply)

FoundationGovernmental organizationHospitalIndustry associationInstitutePrivate clinicResearch facilityScience / Technology parkUniversityOther
(Supplier & Engineering) Select your product/service (check all that apply)

APIs (active pharmaceutical ingredients) and excipientsChemicalsDistributorsElectronicsInstrumentationLaboratory consumables and reagentsLaboratory engineeringLaboratory equipmentMedical devicesPackaging & labelingPrecision mechanicsProduction engineeringSoftwareSynthetic materialsOther
Business Area - If you selected 'other' above, please list any details below
Which service areas are of interest?*

AdministrationArtificial IntelligenceBiomarkersBiometricsBiospecimenChemistry & MfgClinical DevelopmentClinical OperationsDCTFull ServiceMarket AccessPre-ClinicalQuality & ComplianceR&DReal World EvidenceRegulatorySafetySite ManagementSoftware/TechnologySpecialty StudiesTechnologyTrial Supply ManagementOutsourcingOther
(Administration) Select your service areas of interest (check all that apply)

Business DevelopmentCBOCCOCEOCFOChairpersonCommercial OperationsCOOCSOCTOEquity and Capital MarketsFinanceFounder/Co-founderHuman ResourcesLicensingPresidentProgram ManagementStrategyOther
(Artificial Intelligence Service Areas) Select your service areas of interest (check all that apply)

Literature ReviewPatient RecruitingPharmacovigilanceTrial DesignOther
(Biomarker Types) Select your service areas of interest (check all that apply)

AnalysisDigitizationIdentificationImagingRadiosynthesisValidationOther
(Biometrics Service Areas) Select your service areas of interest (check all that apply)

AnonymizationBioinformaticsBiostatisticsData AnalyticsData ManagementData VisualizationDSMB SupportFunctional Service Provision (FSP)Genomics AnalysisRandomizationStatistical ProgrammingOther
(Biospecimen Services) Select your service areas of interest (check all that apply)

Central LabDisposalLocal LabProcurementStorageOther
(Chemistry & Mfg Service Areas) Select your service areas of interest (check all that apply)

CDMOCMC StrategyCMOFilling & PackagingFormulationOther
(Clinical Development Consultancy Areas) Select your service areas of interest (check all that apply)

Adaptive TrialsFeasibilityPharmacologyPKPDPre-Clinical PlanProtocol DesignTranslational MedicineTrial DesignOther
(Clinical Operations Service Areas) Select your service areas of interest (check all that apply)

Central LabClinical Trial SuppliesComparator SourcingDiagnostic/Device ComplianceLocal LabPhase 1 UnitProject ManagementStudy MonitoringOther
(DCT Service Offerings) Select your service areas of interest (check all that apply)v

Digital HealthDigital MeasurementseClinicalHome NursingPatient AdherenceRemote MonitoringOther
(Scope of Full Service) Select your service areas of interest (check all that apply)

Early PhaseLate PhaseOther
(Market Access Service Offerings) Select your service areas of interest (check all that apply)

Commercial PlanGlobal Market SizingGlobal PricingHEORMarket LandscapingMedical InformationPackaging ManagementPayer, Patient And Provider SolutionsPopulation HealthPricing & ReimbursementOther
(Pre-Clinical Services) Select your service areas of interest (check all that apply)

In Vitro Lead Candidate IdentificationIn Vivo StudiesInsilico StudiesTox StudiesViral Test ValidationOther
(Quality & Compliance Services) Select your service areas of interest (check all that apply)

AssessmentAuditingGMP ComplianceQP ReleaseQuality AssuranceRBQMSupply & LogisticsSystems ValidationOther
(R&D Service Areas) Select your service areas of interest (check all that apply)

Artificial IntelligenceData ScienceDiscoveryTherapeutic Business UnitOther
(Real World Evidence Services) Select your service areas of interest (check all that apply)

FeasibilityLifecycle ManagementMarket AccessPatient RecruitingOther
(Regulatory Services) Select your service areas of interest (check all that apply)

Marketing ApplicationsMedical CommunicationsMedical WritingMedical Writing QCRegulatory AffairsRegulatory PublishingRegulatory StrategyRegulatory SubmissionsTranslation & LocalizationOther
(Safety Services) Select your service areas of interest (check all that apply)

Clinical Trial SafetyEndpoint AdjudicationIRBMedical InformationMedical MonitoringPharmacovigilanceOther
(Site Management Services) Select your service areas of interest (check all that apply)

Investigator ServicesSite AdministrationStudy StartupOther
(Software/Technology Services) Select your service areas of interest (check all that apply)

Customization - ConfigurationCustomization - ProgrammingDeploymentDevelopmentLocalization - DocumentationLocalization - UIUser Acceptance TestingOther
(Specialty Studies) Select your service areas of interest (check all that apply)

Bridging StudiesChallenge StudiesExploratory StudiesInvestigator Initiated StudiesNatural History StudiesOpen Label StudiesProspective StudiesRegistry StudiesOther
(Technology Offerings) Select your service areas of interest (check all that apply)

CTMSeCOAeConsentEDCeTMFIVRSafety DatabaseWearablesOther
(Trial Supply Management Services) Select your service areas of interest (check all that apply)

Interactive Web ResponseOther
(Outsourcing) Select your service areas of interest (check all that apply)*

ProcurementVendor ManagementSourcingSupplier ManagementPartner ManagementOther
Service Areas - If you checked 'other' anywhere above, please list the details below.
Do you have a particular therapeutic focus?

Anti-infectivesCardiologyCardiovascularContraceptionDentalDermatologyEndocrinologyGastroenterologyGynecologyHematologyHepatologyImmunologyImmuno-oncologyInfectious DiseaseInflammationMetabolicMusculoskeletalNephrologyNeurology / CNSNeuromuscularOncologyOphthalmologyOrthopedicsOtologyPediatricsPhysiologyPsychiatryPulmonologyRare DiseaseRespiratoryRheumatologySexual HealthVirologyWomen's HealthWound Care
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(Archive) Investor Ecosystem Questionnaire

General Information

Investor Information