Phoenix Integration Award for Medical Education

Section 1: Basic Information

Nomination Type^* :

Self Nomination

Nominated by Others

First Name^* :

Last Name^* :

Email Address^* :

Mobile no^* : +91

Website :

Upload CV Link^* :

Current Role/Title^* :

Organization/Institution Name^* :

Address ^* : (Specify if personal or organizational)

Brief Overview of Your Work in Medical Education^*(Max 200 words) :

Section 2: Innovation Applied For

List Your Innovations or Projects ^* : (Provide the names and brief descriptions of the key healthcare innovations/projects you have worked on)

Field of Innovation in Medical Education^* :

Innovations Description^* : (max: 300 words) (Provide a detailed overview of your innovations/projects, their features, and objectives)

Impact on Medical Education^* : (max: 500 words) (Describe how your innovations have improved healthcare outcomes, reduced costs, increased accessibility, or addressed key challenges)

Technology Used^* : (max: 300 words) (Explain the technologies, including AI, used in your innovations and their role)

Why Should You Be Chosen for This Award? ^* : (max: 300 words) (Highlight the unique value or transformative impact of your work)

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: (files such as research papers, prototypes, product demo links, user testimonials)

Number of Patents Awarded: (Mention the number and provide brief descriptions, if applicable)

References: (Provide the names and contact details of collaborators or others who can vouch for your innovation.)

Additional Notes:-

1) A progress tracker will allow you to save your application and return later.
2) After submission, you will receive a confirmation email summarizing your application.
3) Selection criteria focus on the innovation’s 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 Integration Award for Medical Education