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Account
First Name
*
Last Name
*
Email
*
Password
*
Confirm Password
*
Phone
*
Send OTP
Resend OTP
Verify OTP
Organization
Name of the organization/startup
*
(Organization name can not be edited)
Founding Year
*
Number of Employees
*
Location (Country)
*
India
Location (State)
*
Select State
Andaman And Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra And Nagar Haveli
Daman And Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu And Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Location (City)
*
Website
Corporate Video (add youtube link)
Upload Logo
(200x200 px)
Upload Banner
(1920x600 px)
Short summary
*
(Max 100 Words)
About the organization/startup
*
(Max 500 Words)
Team
Founder 1 (Name)
*
Founder 1 (email)
Founder 1 (phone)
Founder 1 (linkedin & facebook)
Founder 1 (Photo)
Founder 2 (Name)
Founder 2 (email)
Founder 2 (phone)
Founder 2 (linkedin & facebook)
Founder 2 (Photo)
Contact Person (Name)
*
Contact Person (email)
*
Contact Person (phone)
Contact Person (linkedin & facebook)
Contact Person (Photo)
Business
Technology Type (Hardware/Device or Software/App)
*
Select
Hardwar/Device
Software/App
Business Model (B2B or B2C)
*
Select
B2B
B2C
Service Model (SaaS, Marketplace, EULA)
*
Select
SaaS
Marketplace
EULA
Stage (Ideation, Validation, Early Traction, Scaling)
*
Select
Ideation
Validation
Early Traction
Scaling
Where have you implemented earlier ?
Funding
*
Select
Bootstrapped
Incubated
Seat funded
Angel funded
Type of Business (Profit or Nonprofit)
*
Select
Profit
Nonprofit
Women Founded Business? (Yes or No)
*
Select
Yes
No
Healthcare Domain
*
Select
Surgical Specialties
Medical Specialties
Diagnostics
Patient Care and Monitoring
Administrative and Operational
Pharmacy and Medication Management
Other
Please Specify
*
Surgical Specialties
*
Select
General Surgery
Cardiothoracic Surgery
Neurosurgery
Orthopaedic Surgery
Plastic and Reconstructive Surgery
Urology
Vascular Surgery
Transplant Surgery
Otolaryngology (ENT)
Ophthalmology
Colorectal Surgery
Anaesthesiology
Obstetrics and Gynaecology
Other
Please Specify
*
Medical Specialties
*
Select
Family Medicine
Internal Medicine
Paediatrics
Geriatrics
Cardiology
Endocrinology
Gastroenterology
Nephrology
Pulmonology
Rheumatology
Haematology
Oncology
Infectious Diseases
Allergy and Immunology
Dermatology
Neurology
Psychiatry
Physical Medicine and Rehabilitation
Critical Care Medicine
Sports Medicine
Emergency Medicine
Other
Please Specify
*
Diagnostics
*
Select
Radiology
Pathology
Nuclear Medicine
Microbiology
Biochemistry
Histochemistry
Genetic
Other
Please Specify
*
Patient Care and Monitoring
*
Select
Telemedicine Platforms
Patient Portals
Nuclear Medicine
Real time Locating Systems (RTLS)
Bed Management Systems
Unified Communication Systems
Nurse Call Systems
Care Team Collaboration Tools
Other
Please Specify
*
Administrative and Operational
*
Select
Hospital Information System (HIS)
Practice Management Software
Revenue Cycle Management
Patient Scheduling Systems
Electronic Health Records (EHR)
Computerized Physician Order Entry (CPOE)
PACS (Picture Archiving and Communication System):
Laboratory Information Systems (LIS)
Other
Please Specify
*
Pharmacy and Medication Management
*
Select
Pharmacy Information Systems
Automated Dispensing Cabinets
Medication Administration Systems
Other
Please Specify
*
Are you looking for hospital support
*
Select
Yes
No
Do you require funds
*
Select
Yes
No
Area of Impact
(Max 500)
*
USP
*
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