Digital Therapeutics Application - The OPEN MINDS Service Excellence Institute

Name Of Therapeutic(Required)

Name Of Contact(Required)

First Last

Email(Required)

Phone(Required)

Website(Required)

Company LinkedIn

Company Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Describe your digital therapeutic in a few sentences.(Required)

Describe Your Unique Value Proposition(Required)

Who is the end-user of the digital therapeutic?(Required)

Are you FDA cleared or authorized?(Required)

How is your product primarily used – for screening and diagnostics, as a treatment, or in another capacity?(Required)

Please upload any supporting documents.

Max. file size: 98 MB.