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Client Intake Form
Welcome to your onboarding form! Please complete all fields to help us prepare and deliver a smooth licensing process. If you have any questions, contact
[email protected]
.
🔹 Section 1: Company & Contact Info
*
Indicates required field
Company Name
*
Country of Headquarters
*
Website
*
Primary Contact Name
*
First
Last
Title / Role
*
Email
*
Phone Number (with Country Code)
*
🔹 Section 2: Tier & Services
Select your service tier and let us know if you require any additional services
Chosen Tier
*
Health Canada License Review
Guided Licensing
Full-Service Licensing
Full-Service + Market Entry (including KOL access & support)
I'm Not Sure
Any additional options?
*
Option 1
Option 2
Option 3
🔹 Section 3: Device Information
If submitting more than one device, please complete this form once per device or contact us for bulk support
Device Name
*
Brief Description / Intended Use
*
Product Category
*
(e.g. catheter, monitor, infusion pump, etc.)
Device Class (estimated)
*
Class I
Class II
Class III
Class IV
Unsure / need support determining
Has this device been licensed in other markets?
*
CE Marked
FDA Cleared / Approved
ISO 13485 Certified
Other
No licenses yet
If other please specify
*
Is your Technical File or Design Dossier complete?
*
Yes
In Progress
No
Need Guidance
🔹 Section 4: Supporting Documents Upload
Upload relevant files (max 20MB each). We will review and confirm receipt via email.
Product Brochure or Specification Sheet
*
Max file size: 20MB
Previous Regulatory Submissions (EU/FDA if available)
*
Max file size: 20MB
ISO 13485 or QA Certificates
*
Max file size: 20MB
Product Labeling / Packaging Artwork
*
Max file size: 20MB
Instructions for Use (IFU)
*
Max file size: 20MB
Safety and Performance Testing Summaries (if available)
*
Max file size: 20MB
Additional Notes or Documents
*
Max file size: 20MB
🔹 Section 5: Preferred Timeline & Notes
When would be ideal for licensing completed by?
*
Any other regulatory concerns or context we should be aware of?
*
(e.g., software involvement, clinical trial requirements, past regulatory rejections, etc.)
✅ Final Step
Once submitted, our team will review your intake and schedule a kickoff call within 2–3 business days.
Submit