TEST Intake Form version 1
The following are the preferred formatting conditions: Times New Roman, minimum font size 11, page size A4, all margins (top, bottom, left and right) should be at least 20 mm and at least single line spacing. Text elements other than the body text, such as headers, foot/end notes, captions, formula's, may deviate. Once complete, save the file as a PDF document, upload and submit it. Please note that you will no longer be able to change your application form once you click on Submit.
This form will be shared with all MedPhab partners on confidential basis. However, if the company has reasons for not sharing the information with a specific partner (s) the company can select those partner(s) to be excluded in section 5 of this in-take form. The company is not expected to share any IP sensitive information while filling out this form.
Provide a short summary of your new product or service (max. 1 page). If required, you can add a figure describing your product as well.
Describe the technical problem you would like to solve (max. 1 page). Please indicate if certified fabrication (ISO13485) is needed. If required, you can add a figure explaining the problems to be solved as well.
