Phoenix Innovation Award

Section 1: Basic Information

Full Name of Organization^* :

Field of Organization ^* :

Founder or Representative Applicant Name^* :

Role/Designation^* :

Email Address^* :

Mobile no^* : +91

Website :

Social Media Profile Links :

City^* :

Country^* :

Address ^* : (Specify if personal or organizational)

Section 2: Innovation Applied For

Name of the AI Innovation/Product/Service ^* : (Provide the official or commonly recognized name of the innovation )

Field of Innovation in Healthcare^* :

Innovations Description^* : (max: 300 words) (Provide an overview of your product/service, including features, goals, and AI capabilities)

Impact on Healthcare^* : (max: 500 words) (Describe how your innovation has improved patient outcomes, enhanced efficiency, reduced costs, or addressed accessibility challenges. Include measurable results where possible)

Future Roadmap^* : (max: 300 words) (Explain your plans for scaling, enhancing, or evolving the innovation)

Why You Deserve This Award ^* : (max: 300 words) (Highlight the uniqueness and transformative potential of your innovation)

Previous Awards or Recognition : (List any awards, certifications, or recognitions you have received for this or similar innovations)

Section 3: Supporting Documentation

Please Upload your Google Drive link: (Examples:Pitch Decks,Case Studies,Product Demo Links,User Testimonials Research Papers)

Awards or Recognition: (List prior awards, certifications, or recognitions received for this innovation)

Patents: (Indicate the number of patents awarded, if applicable. Provide details as needed)

Revenue or Scaling Metrics: (Share financial or growth metrics to validate your organization’s performance or scalability)

Team Details: (bios or profiles of key team members involved in the innovation" id="team_details)

Additional Notes:-

1) The form is designed to allow saving and resuming applications
2) Confirmation emails will summarize all submitted information.
3) Selection criteria include innovation, healthcare impact, scalability, sustainability, and technology integration.

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 Innovation Award for HealthInnovation