Registrationform Niersfund eHealth Voucher

1. Personal details

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1. Personal details (2)

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1. Personal details (3)

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1. Personal details (4)

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1. Personal details (5)

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1. Personal details (6)

2. Project idea 

(What do you aim to achieve?)

(Why is there a demand? Avoid a pure ‘technology push’) 

3.  Innovative nature of the idea 

(Why is the idea unique? What makes it innovative?)

(For which patients or groups is it relevant?) 

(How does it align with “high tech, human touch”?)

4. Feasibility of the idea 

(How does the idea work in practice?)

(Is it technically feasible? Why?

(For what purpose will the voucher funding be used?)

(Who will develop the idea in the coming years, and when?) 

5. Financial conditions 

6. Uploads

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6. Uploads (2)

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6. Uploads (3)