Thank you for your interest in the Legal Services. Please use this form to provide information about your company and solution. All questions require a response.

If you have any question or need assistance please e-mail info@ehealth-hub.eu

Eligibility criterion: SME with headquarters in Europe*

IMPORTANT: 
Typeform is very cool BUT does not let you save and finish your application later. So we highly recommend saving your responses in a separate word document. Just in case.

*Albania • Austria • Belgium • Bosnia & Herzegovina • Bulgaria • Croatia • Cyprus • Czech Republic • Denmark • Estonia • Finland • Former Yugoslav • Republic of Macedonia • France • Germany • Greece • Hungary • Iceland • Ireland • Israel • Italy • Latvia • Liechtenstein • Lithuania • Luxembourg • Malta • Montenegro • Netherlands • Norway • Poland • Portugal • Romania • Serbia • Slovakia • Slovenia • Spain • Sweden • Switzerland • Turkey • UK
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You and your company

 
Company name *

 
First name *

 
Last name *

 
Job Title *

 
Phone *

Starting with the international dialing code.
Example : 0033 for France.
 
Company headquarters (Country) *

 
Company website *

 
Company Logo

 
Company Twitter

 
Company LinkedIn

 
Year the company was founded *

 
Number of employees *

 
Brief description of your product/service *

Short description of product/service with emphasis on uniqueness of the business
 
Please provide a detailed overview of your legal question(s). Include dates, previous advice, actions taken and your objectives. *

 
Data protection *

We do hereby inform you that the data you have sent us by way of this electronic form shall be included in the information systems of TicBiomed as eHealth Hub project coordinator. Said communication shall be used to deal with your request, as well as to send any information which may be of interest to you about the project activity. By indicating your data, and pursuant to the stipulations of article 6 of the L.O.P.D., you are granting your clear consent to TicBiomed, Tecnologías de la Información de la Región de Murcia to process, in compliance with the purposes mentioned in the previous paragraph above, the personal data provided up to three years after the project end. Notwithstanding, at any time you may exercise your rights of access, rectification, objection and, where applicable, cancellation, at the address: CEEIM, Campus Universitario de Espinardo, 7, Espinardo, 30100 MURCIA or at the e-mail: lopd@ticbiomed.org
     
 
I authorize ehealth Hub to upload my commercial information to the eHealth Hub platform and reports. *

We will create a profile for your organisation in https://platform.ehealth-hub.eu so that you gain access to collaboration opportunities
     
Thank you for your registration! We will contact you.
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