Apply for Funding

Personal Information

First Name

Last Name

Email Address

City

State

Zip

Company Information

Company Name

Website

Tell us about your company. (200 Characters or less)

How much money are you looking to raise?

How much have you raised to date and from whom?. (1000 Characters or less)

Application

Concept

Describe your business in 3500 characters or less. Please include What it is. Who it serves. The healthcare industry problem it solves. Who are the competitors? Who is doing something similar now and how are you different? What are the three biggest challenges/obstacles to the business? How you would use Quantum Medical Concepts' non-financial resources. Any info you can share about the specific healthcare related niche you are targeting (market size, growth trends, etc)

Describe your team in 3500 characters or less

Please include Brief bios on you and your key team members. Anything you want to share on why you are the right team and/or what other slots you need to fill.

Describe the financial characteristics of your business in 3500 characters or less

Please include the following: Financial model. Expected expenses and startup costs for 24 months. Cash-flow forecast through break-even. How you would use Quantum Medical Concepts’ investment?

CAPTCHA

   _____     ___       _____     ___     ______   
  / ___//   / _ \\    / ___//   / _ \\  |      \\ 
  \___ \\  | / \ ||   \___ \\  / //\ \\ |  --  // 
  /    //  | \_/ ||   /    // |  ___  |||  --  \\ 
 /____//    \___//   /____//  |_||  |_|||______// 
`-----`     `---`   `-----`   `-`   `-` `------`

Please enter the leters above to verify that you are a human