New CBIT Project Intake Form
Have an idea? Want CBIT to help make it a reality? Please fill out the form below!
Date *
- {name}
Full Name *
- {name}
Email *
- {name}
Other modes of Contact *
What's the best way to reach you?
- {name}
Yale/YNHHS Department or Affiliation *
Project Intake form must be filled out by a team member who has a Yale-affiliation
- {name}
Innovator *
What medical need are you trying to address? What is your proposed solution? *
- {name}
Do you already have a team? If so, please list your other team members and their department or background. *
Format as "Member Name (Last, First), Yale University Affiliation (or "None"), Undergraduate/Graduate Student/Faculty/Researcher/Professional/Other"
- {name}
Project description *
- {name}
How can CBIT help? What do you need to move your project forward? *
- {name}
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