SimDH Application Form

Thank you for your interest in joining the SimDH Programme. Please complete this application form by Sunday 15th January 2023, 11:59pm.

If you have any questions about this form or need support to complete it, please email simdh@lsbu.ac.uk

Before completing this form, please take a moment to read our Privacy Policy.

Completing the Application

This application form has two parts:

1. Company Information & Eligibility

This will collect your personal details, your company details, and ask about your product/process/service. You will have the opportunity to inform us about the support you require, and to upload any documentation you feel will support your application. You will only be required to compete this section if you are interested in receiving business support through workshops and one to one consultancy only.

2. Academic Support

Only complete this section if you are interested in receiving academic support through SimDH to potentially develop your product or services to market launch. Please note the SimDH Programme end date is 30th June 2023. All product development delivery for all SME members of the programme must be completed by 30th June 2023. If you are not looking to enter a collaboration with SimDH's academic experts, please do not complete the second form.

Once you have completed the SimDH Application form, you will receive a link from a member of the SimDH team via email to the Academic Support form.

Eligibility Criteria

Please note to be eligible to join the SimDH programme your business must:

Be registered in Greater London, or registered in the UK with an operational address in Greater London (co-working spaces or virtual offices are fine)
Be a digital health company - a company which relies on technology as an advantage in its products and is operating or looking to trade within the health and wellbeing sector
Have received less than €200,000 in the last 3 years
Have no more than 25% ownership residing in entities with: more than 250 employees, an annual turnover above €50m and/or a balance sheet above €43m

If you are unsure whether you meet the above criteria, please contact hello@sbi.business prior to submitting your application.

1. Company Information & Eligibility

Your Details

First name*

Last name*

Email*

Phone number*

Please confirm you provide consent to your contact details being stored for the purposes outlined within the privacy notice.*

How did you hear about the SimDH Programme?

If you selected 'other', please describe where:

Company Overview

Company name*

Company Registration CRN or Tax Reference UTR*

A CRN or UTR is required as part of our eligibility criteria.

Registered company post code*

If registered outside of London, please provide an operational postcode within Greater London

Business Industry*

What digital health category applies to your innovation?*

If multiple apply, please select the primary category.

If you selected other, please list what category applies to your innovation?

Only list categories that are not included in the drop down menu.

Please provide a brief summary of your business:*

Maximum 250 words.

Who is your primary customer?*

Who are the key people in the business?*

Provide their roles and areas of expertise. (Please only list your company team members and not associated third parties)

What would you like to achieve in the next 3 months?*

Select multiple if appropriate.

Access the NHS

Medical Device Certification

Raise funds or securing grants

Protect your intellectual property

Build an MVP

Demonstrate product effectiveness through independent evaluation and research

Launch product to market

Is your company currently part of, or planning to join any other support programmes or networks? If so, please list:*

Please confirm if you consent to the details provided in this form being stored for the purpose of reviewing your application and contacting you to discuss next steps.*

Supporting Documentation: please upload any documents you think would be useful in support of your application (multiple files accepted).

If you have any documents that will provide some insight into your business and current stage of development, please upload them here. Suggestions include a research roadmap, pitch deck, financial model or executive summary.

Relationships with NHS

For example NHSX, AHSN's, Trusts.

Have you done any market research?

If yes, please provide a brief outline of the target market, main competitors etc. (max 250 words).

Please describe your business model:

Product Overview

Please tell us about the health tech innovation you're looking for support with:

Please describe what the product or service does.

How many people are currently working on your venture?

Please state the number of FTE.

What is the unique selling point of your health tech innovation?

Milestones (Product development)

Give a brief overview of the milestones and approximate timelines (max 250 words).

Supporting Information Application

Supporting Documentation: please upload any documents you think would be useful in support of your academic collaboration proposal (multiple files accepted).