Form 1 Survey

1. NIH CAP Feedback Form

Form Approved
OMB No. 0925-0627
Exp. Date 4/2017
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
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unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive,
MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0627). Do not return the completed form to this address.

NIH is very interested in your experience with and your feedback about NIH’s Small Business Innovative Research (SBIR)/Small
Business Technology Transfer (STTR) Commercialization Assistance Program (CAP). We hope the CAP was helpful in meeting your
needs.
Please take approximately 15 minutes to answer all of the questions on the feedback form below as comprehensively as possible. The
information is for internal use only. For any question that is not relevant to you, please indicate “Not Applicable” (N/A). You may add
comments to clarify any answer or add additional information.
Thank you! Your feedback is very valuable to us and will help us improve the CAP in the future.

* 1. Please indicate the effectiveness of the CAP in each category. (1 is least, 5 is most). Some of these
questions are dependent on your business model and targeted outcome, so all may not be appropriate.
Indicate “Not Applicable” (N/A) where necessary.
1

2

3

4

5

n/a

Assess your intellectual
property and freedom to
operate strategy
Improve your
business/strategic plan
Develop a licensing
package
Prepare for an FDA
submission
Prepare and/or develop
a reimbursement
strategy
Identify and/or connect
with potential equity
investors
Identify and/or connect
with strategic alliance
partners
Develop management
tools for future use
Develop your
presentation materials
and improve your
presentation skills
Comments:

* 2. Did your principal advisor perform to your satisfaction, in terms of their professionalism, expertise, and
amount of effort and interest that they provided to you?
Yes
No
Comments:

2. NIH CAP Feedback Form

* 3. The use of Other Advisors is an important component of the CAP. Please indicate the quality of expertise
provided by the advisors you were introduced to during the program. Not all types of advisors were needed
by every participant, so indicate N/A where necessary. The PA is not included as an Other Advisors. (1 is
poor, 5 is excellent)
1

2

3

4

5

n/a

Legal Advisors
Industry Advisors
Regulatory Advisors
Reimbursement Advisors
Investment Advisors
Marketing/branding
Advisors
Overall value added by
working with professional
service advisors
Comments:

* 4. Did the Larta team perform to your satisfaction, in terms of their professionalism, timeliness, helpfulness,
and communication skills?
Yes
No
Comments:

* 5. When you started the CAP, did you have a clear understanding of how your participation with the CAP
might help with your commercialization efforts?
Yes
No
Comments:

* 6. Was the amount of effort required to complete the CAP what you expected when you enrolled?
Yes
No
Comments:

3. NIH CAP Feedback Form

* 7. In your judgment, did you invest the effort required for the CAP?
Yes
No
Comments:

* 8. Please estimate the total number of hours per month you and your colleague(s) spent on the CAP.

* 9. Overall, was the CAP worth your time and effort?
Yes
No
Comments:

* 10. Would you recommend the CAP to other SBIR/ STTR grantees?
Yes
No
Comments:

11. Please provide comments, ideas, and/or suggestions for improving the CAP that may not have been
brought out by the previous questions.