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NKF Innovation Fund – Innovator Intake Form
Thank you for your interest in the NKF Innovation Fund.
Our goal is to improve the lives of kidney patients by identifying and investing in innovative technologies and products. We ask that you complete this form to help us learn about your company and evaluate its potential participation in the NKF Innovation Fund.
Contact and Company Information
Company or Organization Name
*
Representative Name
*
Contact Email
*
Contact Phone
*
Website Link
Describe the goal of your company
*
Do you currently have a Governing or Advisory Board?
*
- Select -
Yes
No
If yes, please upload a list of your Governing or Advisory Board members here
*
Files must be less than
2 MB
.
Allowed file types:
gif jpg jpeg png txt rtf pdf doc docx ppt pptx xls xlsx
.
Describe your current funding status
*
- Select -
Seed funding
Series A
Series B
Other...
Describe your current funding status Other...
Product Information
Describe your company’s product:
*
What is the value proposition of your company’s product?
*
Who are the end-users of your product? (transplant patient, dialysis patient, transplant surgeon, primary care doctor, dialysis provider, etc.)
*
How will your product improve quality of life and quality of treatment for kidney patients?
*
Which patient population(s) do you expect to benefit from your product?
*
- Select -
Prekidney disease
CKD
ESRD
Dialysis patients
Transplant Recipients
Other...
Which patient population(s) do you expect to benefit from your product? Other...
Describe your product's expected patient impact, both in terms of number of patients reached and degree of impact per patient:
*
How long will this product take to develop and reach patients or consumers?
*
Which category best describes your product?
*
- Select -
Artificial Kidney
Xenotransplantation
Wearable or Portable Dialysis
Home Dialysis
Dialysis Innovation or Enhancement
Fistula Support
Prevention or slowing of kidney disease
Other...
Which category best describes your product? Other...
Describe your company’s leadership team and the experience and qualifications of its key members. You can provide this as an uploaded document or you can type it in:
*
- Select -
Upload
Type in
Upload Single Document
*
Files must be less than
20 MB
.
Allowed file types:
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.
Type in description
*
Describe your company’s current finances, including funds raised to date, burn rate, cash on hand, future fundraising rounds planned, etc. You can provide this as an uploaded document or you can type it in
*
- Select -
Upload
Type in
Upload Single Document
*
Files must be less than
20 MB
.
Allowed file types:
gif jpg jpeg png txt rtf pdf doc docx ppt pptx
.
Type in description
*
What regulatory challenges do you anticipate to secure FDA approval of your product, and how do you envision overcoming them?
*
Summarize your company’s existing Intellectual Property:
*
What else would you like us to know about your product or company?
*
Other Materials
Please upload a document with any other materials you believe would be helpful in our evaluation (slide decks, executive summaries, etc.)
If you have multiple documents, please combine them in to one document before submitting.
Files must be less than
20 MB
.
Allowed file types:
gif jpg jpeg png txt rtf pdf doc docx ppt pptx xls xlsx bz2 dmg gz jar rar sit tar zip
.
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