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

For more information, contact Nicole Häusler ( or Björn Hackbarth (

Eligibility criterion: SME with headquarters in Europe*

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
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
Your regulatory and reimbursement challenge

* Regulatory challenge

* Reimbursement challenge

* Specify your current regulatory and reimbursement challenge

Please elaborate on your challenge and specify the countries in which you need our support.
Data protection *

By submitting this form, you allow us to keep the information provided in our database, in order to send you information about the eHealth HUB project.

The details you submit through our website or in any other manner will be included in a file held by TICBioMed, Tecnologías de la Información de la Región de Murcia. You can exercise your rights of access, amendment, erasure and objection by contacting
I give eHealth Hub permission to publish the videos and photographs taken in their events *

Thank you for your registration! We will contact you.
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