MSIP Entrepreneurship Bootcamp 2021 Application

Any Questions?

Contact Dov Shamir, PhD, Senior Manager of Education and Entrepreneurship at dov.shamir@mssm.edu

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* 1. First Name

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* 2. Last Name

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* 3. E-mail

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* 4. Are you affiliated with the Mount Sinai Health System?

Yes

No

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* 5. Title/Position (e.g. Professor, PhD or MD student, PostDoc, Program Manager, etc)

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* 6. Please describe a healthcare problem that you are interested in solving.

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* 7. Have you begun to create a solution to that problem? If so, please generally describe the solution.

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* 8. What stage of development is your solution?

Concept

Mockup

Early Prototype

Late Prototype

Not Applicable

Other (please specify)

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* 9. Have you disclosed this solution to Mount Sinai Innovation Partners?

Yes

No

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* 10. What resources, advisory, or expertise do you think you would need to complete your solution?

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* 11. Can you commit 1-2 hours a week from October 2 to December 18 for the scheduled Friday modules?

Yes

No

Other (please specify)