HTC15 Exhibitor Venture & Match Maker

ALL APPLICANTS

PLEASE NOTE THAT THE VENTURE COMPETITION AND MATCH MAKER PROGRAM ARE ONLY AVAILABLE TO PAID EXHIBITORS. IF YOU HAVE NOT REGISTERED YET, PLEASE DO SO AT WWW.HEALTHCARECONFERENCE.COM - THANK YOU!

Welcome to the HealthTech Conference Exhibitor Information Survey, which has three parts.
1. Basic information from everyone
2. Extra information for the Venture Competition
3. Extra information for the Match Maker program

The Venture Competition summary will be provided to the venture judges ahead of the conference.
The Match Maker submission will be provided to potential customers and partners to help them select whom they wish to meet.

After you submit this application, you may revisit and update your information (use the same link and SAME COMPUTER from which you entered the data).

Everyone: Please send your Company Logo to Gary Wiener (gary@healthtechconference.com)
Gary also will be happy to answer any questions that you may have.

Thank you.

For Venture Competition Applicants ONLY
Once you complete your survey, you are welcome to send additional relevant materials to Gary Wiener (gary@healthtechconference.com). THIS IS OPTIONAL.
Such files may include:
- Executive Summary
- Financial Projections
- Investor Slides
- DEMO link or video
- Business Plan

Question Title

* 1. COMPANY INFORMATION

Contact Name (Person): *

Company: *

Address 1: *

Address 2:

City/Town: *

State/Province: *

ZIP/Postal Code: *

Country: *

Email Address (Contact Person): *

Cell Phone Number (Contact Person): *

Question Title

* 2. REFERRED BY

Question Title

* 3. COMPANY WEBSITE

Question Title

* 4. WHEN WAS COMPANY WAS FOUNDED (month/year)?

Question Title

* 5. NUMBER OF EMPLOYEES

0-5

5-10

10-20

20+

Question Title

* 6. WHAT IS YOUR PRIMARY INDUSTRY SECTOR?

Diagnostic

Employer Tools

Genomics & Biotools

Home Healthcare

Hospital Tools

Long-Term Care

Medical Devices and Equipment

Patients Tools

Payers Tools

Physician & Clinics Tools

Regulatory

Reimbursement

Wellness and Fitness

Other (please specify)

Question Title

* 7. BRIEFLY DESCRIBE YOUR COMPANY

Question Title

* 8. WHAT CUSTOMER PROBLEM ARE YOU SOLVING?

Question Title

* 9. DESCRIBE YOUR SOLUTION

Question Title

* 10. BRIEFLY SUMMARIZE YOUR VALUE PROPOSITION

Question Title

* 11. WHAT IS YOUR URL FOR YOUR VALUE PROPOSITION VIDEO (3 minutes max) ?

Question Title

* 12. HOW ARE YOU VALIDATING YOUR VALUE PROPOSITION?

Question Title

* 13. WHAT STAGE IS YOUR VALIDATION?

Prototype

Pilot started

Pilot validated

Paying customers (1-5)

Paying customers (6-10)

Paying customers (11-100)

Paying customers (101 - 1,000)

Paying customers (1,000+)

Question Title

* 14. WHO ARE YOUR PRIMARY CUSTOMERS? (who pays you?)

Providers: hospitals, clinics

Payers: Insurance, CMS, employers

Patients: Consumers

Pharma

Question Title

* 15. WHAT IS YOUR BUSINESS MODEL?

Question Title

* 16. WHAT ELSE WOULD YOU LIKE TO TELL US?

Question Title

* 17. CONTINUE TO (after choosing, you must click "Next" at the bottom)

Venture Competition AND Match Maker options

Match Maker ONLY (without applying to Venture Competition)

End of Survey