Fast Track Your Idea Step 1: A Bit About You Tell Us About Yourself First Name * Last Name * Jefferson Affiliation * Employee/Faculty Student Alumni Other Affiliation/Unaffiliated Street Address Apt/Suite/Office City State Zip or Postal Code Country Email Address * Telephone Mobile Number Additional Information To be completed as applicable. Title Department College Sidney Kimmel Medical College Jefferson College of Architecture & the Built Environment Kanbar College of Design, Engineering, & Commerce Jefferson College of Health Professions Jefferson College of Humanities & Sciences Jefferson College of Life Sciences Jefferson College of Nursing Jefferson College of Pharmacy Jefferson College of Population Health Jefferson College of Rehabilitation Sciences Jefferson School of Continuing & Professional Studies Step 2: Collaborators Please list anyone you have collaborated with, or who may have a claim to part of all of this idea. * Step 3: Basics of Your Idea The Elevator Pitch: In 10 words or less, what is your idea. * In 200 words or less, please describe your idea. Use lay terms where possible. * Have you searched the following to determine if similar ideas exist: * Google Bling Yahoo NIH Other Search Options Describe other searches performed? What was the result of the searches that you performed? Include relevant URLs. * Step 4: The Need What problem will your idea solve? * Who needs your Innovation—who will use it and who will be the main recipient of its benefits? Who will pay for its use? How is this need currently being met? Who is the ultimate buyer of the product? (Physician, consumer, hospital, Pharma, etc?) Describe the current and upcoming competitive landscape. * Are there any technologies currently on the market or in development that claim to meet the same needs as your Innovation? What are the advantages of your Innovation? Describe the technology that will enable your Innovation. What are the components that will be required to create your final product? Will you develop or acquire these other components? Step 5: Considerations Have you ... Had a patent issued naming you as an inventor? * Yes No Had technology licensed to an existing company (not a start-up)? * Yes No How would you rank the commercial potential of your Innovation on a scale of 1-5? * 1 2 3 4 5 Other Considerations Have you garnered the interest of people outside of Jefferson? * Yes No Have you identified funding sources for your idea? * Yes No Submit