Phoenix Impact Award

Section 1: Basic Information

Applicant Type ^* :

Individual

Organization

Name (For Individual Applicants or Organizational Applicants)^* :

Individual / Organisation Category^* :

Email Address^* :

Mobile no^* : +91

Website :

Linkedin Profile Links :

Brief Overview (Individual or Organization) ^* : (Max 200 words) (Describe your role and contribution to healthcare. Provide an overview of your mission, vision, and key contributions to enabling the healthcare ecosystem)

Section 2: Innovation Applied For

Field of Impact in Healthcare ^* :

Impact Initiatives or Projects^* : (Max 300 words) (List your major initiatives/projects contributing to healthcare improvement.Include brief details such as the name, goal, and scope)

Evidence of Impact^* : (max: 500 words) (Describe measurable outcomes, such as improved patient outcomes, healthcare efficiency, cost reductions, or enhanced accessibility. Provide statistics, case studies, or real-world examples)

Sustainability and Scalability ^* : (Max 300 words) (Explain how your initiative is sustainable in the long term and scalable across regions or demographics)

Challenges and Solutions : (Max 300 words) ^* : (Max 300 words) (Describe challenges you faced during implementation and how you overcame them)

Why You Deserve This Award ?^* : (max: 300 words) (Highlight what sets you or your organization apart)

Section 3: Supporting Documentation

Please Upload your Google Drive link: (Examples: Reports, Testimonials, Case Studies, Photos, Videos, Product Demos, etc.)

Awards or Recognition: (List prior awards, certifications, or recognitions relevant to your impact.)

Revenue, Scaling, or Reach Metrics : (Share any financial, growth, or reach metrics to validate your success)

Collaborators or Partners : (List key collaborators or partners involved in your projects.)

Additional Notes:-

1) Applicants can save progress and resume later.
2) Submitted applications will receive a confirmation email summarizing the details.
3) Selection criteria will focus on measurable impact, scalability, sustainability, and innovation.

Declaration:-

I confirm that the information provided is accurate to the best of my knowledge.

I agree to the terms and conditions for participating in the award selection process.

Application Form: Phoenix Impact Award for HealthInnovation