Innovation Ventures
Innovation Ventures

Innovation Ventures Outside-In Intake Form

* Company Name

* Submitter's First Name

* Submitter's Last Name

* Submitter's Email

* Are you affiliated with the company?

Yes

No

* What is your role in the company?

* Company Website

* Country

* Street Address

* City

* State

* Zip Code

* Business Phone Number

* Name of Activity/Opportunity

* Project Type

* Description of Project

* What problem are you addressing?

* Describe One or More Use Cases and/or Clients

* What is unique about your Solution/Product? Why is it better than that of your competitors?

* Development Stage of Solution/Product?

* What is your status with Cincinnati Children's? Have you had any previous contact with any Cincinnati Children's employee about this opportunity?

* Your expectations from Cincinnati Children's. What is your desired outcome of a relationship with Cincinnati Children's?

* Please List Any Potential Conflicts of Interest

Record Type

Contact us for questions regarding payments received, invoice status, or revenue share statements.
innovationventures@cchmc.org

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