Form 1 Post Event Survey

Post Event Feedback Form

Please answer the following questions to assist us in both gauging success and in
selecting future events/showcases. Information will be kept private to the extent
provided by law.
Thank you for your feedback!
OMB No.: 0925-0648
Expiration Date: 06/30/2024
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* BASIC INFORMATION
Company Name
Name of Presented Technology
Your Name
Title/Role
Event Date (Month/Year)
Event Name/Location

About Your Company (Select all that apply):
8(a) Qualified by SBA

* We are trying to better understand the role of women in our small business community.
Please help us by selecting any of the below statements that are true for your company:
My company is majority-owned by a woman or
women

A woman (or women) holds a C-level leadership
role(s) in my company

My company is partially-owned (50% or less) by a
women or women

None of the above are true about my company

My company was founded or co-founded by a
woman or women

* We are trying to better understand the role of underrepresented racial and ethnic groups in
our small business community. Please help us by selecting any of the below statements that
are true for your company:
My company is majority-owned by an
underrepresented racial/ethnic group
My company is partially-owned (50% or less) by
a member(s) of an underrepresented racial/ethic
group

A member(s) of an underrepresented racial/ethic
group holds a C-level leadership role(s) in my
company
None of the above are true about my company

My company was founded or co-founded by a
member(s) of an underrepresented racial/ethic
group

* Technology Area (Select One):
Drug

In Vitro Diagnostic

Device

Research Tool

Health IT and Education

Other (please describe):

* Development Stage of SBIR-Funded Technology (Select One):
Early Stage (in vitro or
untested prototype)
Ongoing (in vivo testing or
refining an early design)
Other (please describe):

EVENT QUESTIONS

Testing in a Clinical Setting
Ready to Commercialize

Commercial Product

* 1. How useful was this event for each of the following?

Not at all

Somewhat

Moderately

Extremely

N/A

Connecting with
potential strategic
partners
Connecting with
potential investors
Connecting with
potential scientific
collaborators
Connecting with
potential customers
Company visibility
and exposure
Gaining insight into
the competitive
landscape
Scientific or medical
education
Learning more about
running your
business

* 2. What were your primary goals for attending this event? (Select your top 2 goals)
Seeking Strategic Partners (large business)

Gaining Insight into the Competitive Landscape

Seeking Investment

Gaining Insight into the Intellectual Property
Landscape

Seeking Scientific Collaborators

Validating Clinical Indications

Customer Discovery

Validating Business Model

Increasing Company Visibility and Exposure
Other (describe below):

* 3. Do you think that you made progress towards achieving that goal?
Yes
No (please describe):

* 4. How valuable did you find the event/showcase as a whole?
Not at all
Comment:

Somewhat

Mostly

Extremely

* 5. Do you believe that the appropriate investors and strategic partners attended?
Yes
No (please list those missing):

* 6. Were there sufficient number of investors or potential partners in attendance interested
in your technology area?
Yes
No (please describe):

7. Select the types of organizations and/or people you met with (select all that apply).
Venture Capital Investors

Potential Scientific Collaborator

Angel Investors

Potential Customer

Potential Strategic Partners (medical
technology/pharma/biotech)

NIH Staff

Other (describe below)

8. How many investors or strategic partners did you meet with
at the event?
* Formal Meetings

with minimal/no interest in my technology
with moderate interest in my technology
with high level interest in my technology

* Informal Meetings

with minimal/no interest in my technology
with moderate interest in my technology
with high level interest in my technology

* 9. Do you feel that you have increased your network with the investment community as a
result of these meetings, either formal or informal?
Yes
No (please describe):

* 10. Are you negotiating and/or have secured any deals with an investor or strategic partner
for this product?

Post Event Feedback Form

Please list any deals that your company has made with
an investor or strategic partner for this product.
* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

Post Event Feedback Form

Please list any deals that your company has made with
an investor or strategic partner for this product.

* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

* Investor/Partner Name and Description of Deal 2
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 2

Deal Status

* NCI Involvement of Deal 2

Involvement of NCI

Post Event Feedback Form

Please list any deals that your company has made with
an investor or strategic partner for this product.
* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

* Investor/Partner Name and Description of Deal 2
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 2

Deal Status

* NCI Involvement of Deal 2

Involvement of NCI

* Investor/Partner Name and Description of Deal 3
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 3

Deal Status

* NCI Involvement of Deal 3

Involvement of NCI

Post Event Feedback Form

Please list any deals that your company has made with
an investor or strategic partner for this product.
* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

* Investor/Partner Name and Description of Deal 2
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 2

Deal Status

* NCI Involvement of Deal 2

Involvement of NCI

* Investor/Partner Name and Description of Deal 3
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 3

Deal Status

* NCI Involvement of Deal 3

Involvement of NCI

* Investor/Partner Name and Description of Deal 4
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 4

Deal Status

* NCI Involvement of Deal 4

Involvement of NCI

Post Event Feedback Form

Please list any deals that your company has made with
an investor or strategic partner for this product.
* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

* Investor/Partner Name and Description of Deal 2
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 2

Deal Status

* NCI Involvement of Deal 2

Involvement of NCI

* Investor/Partner Name and Description of Deal 3
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 3

Deal Status

* NCI Involvement of Deal 3

Involvement of NCI

* Investor/Partner Name and Description of Deal 4
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 4

Deal Status

* NCI Involvement of Deal 4

Involvement of NCI

* Investor/Partner Name and Description of Deal 5
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 5

Deal Status

* NCI Involvement of Deal 5

Involvement of NCI

Post Event Feedback Form

Please list the 5 most relevant deals that your company
has made with an investor or strategic partner for this
product.
* Investor/Partner Name and Description of Deal 1
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 1

Deal Status

* NCI Involvement of Deal 1

Involvement of NCI

* Investor/Partner Name and Description of Deal 2
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 2

Deal Status

* NCI Involvement of Deal 2

Involvement of NCI

* Investor/Partner Name and Description of Deal 3
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 3

Deal Status

* NCI Involvement of Deal 3

Involvement of NCI

* Investor/Partner Name and Description of Deal 4
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 4

Deal Status

* NCI Involvement of Deal 4

Involvement of NCI

* Investor/Partner Name and Description of Deal 5
Name of Investor/Partner
Description of Deal

* Deal Status of Deal 5

Deal Status

* NCI Involvement of Deal 5

Involvement of NCI

Post Event Feedback Form

* 11. How many contacts do you plan to follow-up with?

Potential Investors
Potential Partners
Potential Customers
Other
Other (please describe):

* 12. Did you significantly benefit from the event in any of the following ways?

Did not Benefit
Increased visibility
due to the profile of
the event
Customer/market
need insights for the
NCI-funded project
Product
development
insights for the NCIfunded project
Improved pitch and
ability to showcase
company

Somewhat Benefited

Moderately Benefited

Greatly Benefited

13. Please list or describe any media attention that your company received as a result of
participating in this event:

* 14. Was NCI support a critical factor in your being able to attend this event?
No
Yes (please describe):

* 15. If you have an oral or poster presentation at this event, was it a worthwhile experience?

Yes, both were worthwhile

Yes, the oral presentation was worthwhile

Yes, the poster presentation was worth while
No (please specify)

* 16. If you received mentoring from the NCI SBIR Development Center in preparation for
this event (e.g. pitch coaching), how useful was it?
Not at all

Somewhat

Mostly

Extremely

N/A

* 17. Would you recommend that other companies similar to yours (same stage and/or
technology) attend this event?
Yes
No (please describe):

* 18. Would you have attended without NCI support?
No
Yes (please describe):

* 19. Did you feel that your company's topic area and stage of development fit the focus of the
investors in attendance?
Yes
No (please describe):

20. Comments/ general suggestions: