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Please fill in this form to describe the need that your technology is intended to address, and to help us to understand what help you are seeking.
Name *
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Capacity in which you are submitting this need?
Patient/carer/relative
Industry
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Please describe the clinical or care need for the technology that you are developing (500 characters max)
Please describe your technology (500 characters max)
What would be the primary benefits for patients if your technology becomes available? (500 characters max)
If known, please indicate the long-term condition/s or healthcare problems for which this technology is potentially of value (250 characters max)
How many patients will potentially benefit (estimate)?
Please provide some further information on the stage of development of your technology:
I/we have developed a concept
I/we have developed a design
I/we have developed a prototype
I/we have obtained a CE mark
The technology is in production
The technology is already available commercially
Other (250 characters max)
Please list any existing product(s) which might address this issue (500 words max)
Are you interested in accessing a particular aspect of D4D’s expertise, for example regulatory, signposting, or access to clinical opinions?
I authorise Devices for Dignity to share the project description with selected third parties within the expert network. My personal information (name, email and phone) will not be shared
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