Expression of Interest for Clinical Deployment

Name of organisation(Required)

Type of organisation(Required)

We are a SME/ slightly larger company

We are an end-user

Organisation's address(Required)

Street Address ZIP / Postal Code City Country

Contact Person Name(Required)

First Last

Contact Person e-mail address(Required)

E-mail address verification(Required)

Area of Expertise

Diagnostic Robotics

Interventional Robotics

Rehabilitation Robotics

Robotics supporting Patients

Robotics supporting Healthcare Professionals

Please specify your area of expertise further

Proposed Robotic Application to be deployed in four different countries(Required)

Have you already found Collaboration Partners?(Required)

Yes

No

Who do you want to collaborate with?(Required)

Please note that the project consortium must consist of at least one SME and four end-users located in four different countries.

Do you have a preferred healthcare-related setting the robotic application should be deployed in?(Required)

Please note that the robotic application must be deployed in four different countries.

Area of Interest

Diagnostic Robotics

Interventional Robotics

Rehabilitation Robotics

Robotics supporting Patients

Robotics supporting Professionals

Please specify the added value of your institution? (e.g. multiple fields of expertise, multiple languages spoken by patients, size etc.)

How many employees does your organisation have?(Required)

Are you experienced in international collaborations already?(Required)

Yes

No

What kind of robotic applications would you be interested in?(Required)

Are you already experienced in deploying robots?(Required)

Yes

No

What are from your point of view the needs and requirements that have to be fulfilled in order to deploy a robot sucessfully?(Required)

Further contact of DIH-HERO to answer additional questions concerning the clinical connection and deployment

We agree to being contacted by one of the DIH-HERO partners to answer additional questions concerning the clinical connection and deployment

Sharing information among DIH-HERO consortium partners

We agree that the information given can be shared among the DIH-HERO consortium partners.

Creating a company profile for matchmaking

We agree that the information given can be used to create a profile for matchmaking.

Privacy Statement(Required)

I agree to the privacy statement of DIH-HERO