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https://fpt5pso0.forms.app/healthcareinnovatorsconnect
Submission: On July 07 via manual from SG — Scanned from SG
Submission: On July 07 via manual from SG — Scanned from SG
Form analysis 1 forms found in the DOM
<form data-v-37898f8f="" class="i-form"><!---->
<div data-v-37898f8f="" class="logo-cover-wrapper cover">
<div data-v-630d7724="" data-v-37898f8f="" class="form-cover"
style="background-image: url("https://file.forms.app/formfile/6682718c0ab1f7f72726b441/a66f5dd5-38df-11ef-b4af-0242ac120004"); filter: brightness(100%); background-position: center top; background-size: cover;"></div> <!---->
</div> <!---->
<div data-v-37898f8f="" class="big-question-wrapper"><!---->
<div data-v-15d68788="" data-v-37898f8f="" class="form-header-wrapper">
<div data-v-15d68788="" class="form-title view">
<h1 data-v-15d68788="" class="form-title break-word">We'd like to invite you to shape the future of patient care.</h1>
</div> <!---->
</div>
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<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Name</p>
</div> <!---->
</div>
</div>
<div data-v-37898f8f="" class="question-body question-wrapper required" data-order="1" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div class="full">
<div data-v-e95a78e6="" class="input-field i-text short-input success-input-wrapper">
<div data-v-e95a78e6=""><!----> <input data-v-e95a78e6="" id="i-text-1" placeholder="Prefix" type="text" autocomplete="honorific-prefix" name="name-prefix" class="f-input"> <!----> <!----> <!----> <!----></div>
</div>
<div data-v-e95a78e6="" class="input-field i-text success-input-wrapper">
<div data-v-e95a78e6=""><!----> <input data-v-e95a78e6="" id="i-text-2" placeholder="First Name" type="text" autocomplete="given-name" name="name" class="f-input"> <!----> <!----> <!----> <!----></div>
</div> <!---->
<div data-v-e95a78e6="" class="input-field i-text success-input-wrapper">
<div data-v-e95a78e6=""><!----> <input data-v-e95a78e6="" id="i-text-3" placeholder="Last Name" type="text" autocomplete="family-name" name="last-name" class="f-input"> <!----> <!----> <!----> <!----></div>
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</div>
</div>
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</div>
<div data-v-1ece8eaa="" data-v-37898f8f="" class="question" type="view" id="60b3c8260958cf5da1d792a9" index="1">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Number for WhatsApp. We will use it for easier communication for upcoming events.</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> (Optional but recommended for seamless updates.) </p>
</div>
</div>
<div data-v-37898f8f="" class="question-body question-wrapper" data-order="2" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div class="full"><!----> <!----> <!---->
<div data-v-e95a78e6="" class="input-field i-text prepend-icon success-input-wrapper">
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<input data-v-e95a78e6="" id="i-text-4" type="tel" autocomplete="tel" name="phone" class="f-input"> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question required" type="view" id="60b3c8290958cf5da1d792af" index="2">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Email</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Stay updated with event invitations and our latest news. </p>
</div>
</div>
<div data-v-21d5f07a="" data-v-37898f8f="" class="question-body question-wrapper required" data-order="3" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-21d5f07a="" class="full">
<div data-v-e95a78e6="" data-v-21d5f07a="" class="input-field i-text prepend-icon success-input-wrapper">
<div data-v-e95a78e6="">
<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 512 512"><path d="M464 64H48C21.5 64 0 85.5 0 112v288c0 26.5 21.5 48 48 48h416c26.5 0 48-21.5 48-48V112c0-26.5-21.5-48-48-48zM48 96h416c8.8 0 16 7.2 16 16v41.4c-21.9 18.5-53.2 44-150.6 121.3-16.9 13.4-50.2 45.7-73.4 45.3-23.2.4-56.6-31.9-73.4-45.3C85.2 197.4 53.9 171.9 32 153.4V112c0-8.8 7.2-16 16-16zm416 320H48c-8.8 0-16-7.2-16-16V195c22.8 18.7 58.8 47.6 130.7 104.7 20.5 16.4 56.7 52.5 93.3 52.3 36.4.3 72.3-35.5 93.3-52.3 71.9-57.1 107.9-86 130.7-104.7v205c0 8.8-7.2 16-16 16z"></path></svg></i>
<input data-v-e95a78e6="" id="i-text-5" required="required" type="email" autocomplete="email" name="email" class="f-input"> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question required" type="view" id="6682807c6392b33c3934ea80" index="3">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Job Title</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Knowing your role helps us tailor our content and events to your interests. </p>
</div>
</div>
<div data-v-37898f8f="" class="question-body question-wrapper required" data-order="4" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-e95a78e6="" class="input-field i-text input prepend-icon success-input-wrapper">
<div data-v-e95a78e6="">
<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 448 512"><path d="M448 48v72a8 8 0 0 1-8 8h-16a8 8 0 0 1-8-8V64H240v384h72a8 8 0 0 1 8 8v16a8 8 0 0 1-8 8H136a8 8 0 0 1-8-8v-16a8 8 0 0 1 8-8h72V64H32v56a8 8 0 0 1-8 8H8a8 8 0 0 1-8-8V48a16 16 0 0 1 16-16h416a16 16 0 0 1 16 16z"></path></svg></i>
<input data-v-e95a78e6="" id="i-text-6" required="required" type="text" class="f-input"> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question required" type="view" id="668275796392b33c3934e92d" index="4">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Organization/Company</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Tell us where you work so we can understand your background better. </p>
</div>
</div>
<div data-v-37898f8f="" class="question-body question-wrapper required" data-order="5" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-e95a78e6="" class="input-field i-text input prepend-icon success-input-wrapper">
<div data-v-e95a78e6="">
<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 448 512"><path d="M448 48v72a8 8 0 0 1-8 8h-16a8 8 0 0 1-8-8V64H240v384h72a8 8 0 0 1 8 8v16a8 8 0 0 1-8 8H136a8 8 0 0 1-8-8v-16a8 8 0 0 1 8-8h72V64H32v56a8 8 0 0 1-8 8H8a8 8 0 0 1-8-8V48a16 16 0 0 1 16-16h416a16 16 0 0 1 16 16z"></path></svg></i>
<input data-v-e95a78e6="" id="i-text-7" required="required" type="text" class="f-input"> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question" type="view" id="60b3c8330958cf5da1d792b4" index="5">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">LinkedIn Profile URL</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Connect with us and other community members on LinkedIn. </p>
</div>
</div>
<div data-v-37898f8f="" class="question-body question-wrapper" data-order="6" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-e95a78e6="" class="input-field i-text input prepend-icon success-input-wrapper">
<div data-v-e95a78e6="">
<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 448 512"><path d="M448 48v72a8 8 0 0 1-8 8h-16a8 8 0 0 1-8-8V64H240v384h72a8 8 0 0 1 8 8v16a8 8 0 0 1-8 8H136a8 8 0 0 1-8-8v-16a8 8 0 0 1 8-8h72V64H32v56a8 8 0 0 1-8 8H8a8 8 0 0 1-8-8V48a16 16 0 0 1 16-16h416a16 16 0 0 1 16 16z"></path></svg></i>
<input data-v-e95a78e6="" id="i-text-8" type="text" class="f-input"> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question required" type="view" id="66827adb6392b33c3934ea16" index="6">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">What upcoming date would work for you?</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Select the dates you’re available to ensure your spot at our exclusive events. </p>
</div>
</div>
<div data-v-8feeef96="" data-v-37898f8f="" class="question-body question-wrapper required" data-order="7" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
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<div class="input-choice"><label data-v-7bc40a32="" class="i-checkbox checkbox form-input-choice" required="required"><input data-v-7bc40a32="" type="checkbox" hidden="hidden" tabindex="-1" value="66827adb6392b33c3934ea14"> <span
data-v-7bc40a32="" tabindex="-1"><i data-v-7bc40a32="" class="before-checkbox"></i>
<p data-v-7bc40a32="" class="label-text"><!----> Thursday, 18 July - Building Bridges: Integrating Technology and Evidence for Advancing Lung Cancer Care </p> <!---->
</span> </label><label data-v-7bc40a32="" class="i-checkbox checkbox form-input-choice" required="required"><input data-v-7bc40a32="" type="checkbox" hidden="hidden" tabindex="-1" value="668281726392b33c3934ea94"> <span
data-v-7bc40a32="" tabindex="-1"><i data-v-7bc40a32="" class="before-checkbox"></i>
<p data-v-7bc40a32="" class="label-text"><!----> Wednesday, 24 July - Innovative Pathways: Enhancing Patient Journeys with Cutting-Edge Technology </p> <!---->
</span> </label><label data-v-7bc40a32="" class="i-checkbox checkbox form-input-choice" required="required"><input data-v-7bc40a32="" type="checkbox" hidden="hidden" tabindex="-1" value="66827adb6392b33c3934ea15"> <span
data-v-7bc40a32="" tabindex="-1"><i data-v-7bc40a32="" class="before-checkbox"></i>
<p data-v-7bc40a32="" class="label-text"><!----> Thursday, 1 August - From Data to Discovery: Harnessing Genomic Data for Precision Medicine (Breast Cancer) </p> <!---->
</span> </label><label data-v-7bc40a32="" class="i-checkbox checkbox form-input-choice" required="required"><input data-v-7bc40a32="" type="checkbox" hidden="hidden" tabindex="-1" value="668281a66392b33c3934ea96"> <span
data-v-7bc40a32="" tabindex="-1"><i data-v-7bc40a32="" class="before-checkbox"></i>
<p data-v-7bc40a32="" class="label-text"><!----> Wednesday, 7 August - AI-Powered Care: Transforming Patient Outcomes through Intelligent Solutions </p> <!---->
</span> </label><label data-v-7bc40a32="" class="i-checkbox checkbox form-input-choice" required="required"><input data-v-7bc40a32="" type="checkbox" hidden="hidden" tabindex="-1" value="668281a66392b33c3934ea95"> <span
data-v-7bc40a32="" tabindex="-1"><i data-v-7bc40a32="" class="before-checkbox"></i>
<p data-v-7bc40a32="" class="label-text"><!----> Thursday, 15 August - Decentralized Trials: Leveraging Telehealth for Inclusive Patient Recruitment </p> <!---->
</span> </label> <!----></div> <!---->
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<div data-v-3522cdce="" tabindex="-1" class="for-only-validation"><input data-v-3522cdce="" readonly="readonly"></div> <!---->
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question" type="view" id="60b3c8810958cf5da1d792be" index="7">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
<div data-v-1ece8eaa="" class="align-column"><!---->
<div data-v-1ece8eaa="" class="question-info"><!---->
<div data-v-1ece8eaa="" class="question-title-wrapper">
<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Do you have any specific topics you’d like to see covered in our events?</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Your input helps us plan content that matters to you. </p>
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<div data-v-37898f8f="" class="question-body question-wrapper" data-order="8" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-e95a78e6="" class="input-field i-text textarea prepend-icon success-input-wrapper">
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<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 448 512"><path d="M280 48H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h272a8 8 0 0 0 8-8V56a8 8 0 0 0-8-8zm160 384H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h432a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8zM280 304H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h272a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8zm160-128H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h432a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8z"></path></svg></i>
<textarea data-v-e95a78e6="" id="i-text-9" class="f-input"></textarea> <!----> <!----> <!----> <!----></div>
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<div data-v-1ece8eaa="" data-v-37898f8f="" class="question" type="view" id="668275d46392b33c3934e958" index="8">
<div data-v-1ece8eaa="" class="question-card-scroll first-question-column">
<div data-v-1ece8eaa="" class="question-card-wrapper">
<div data-v-1ece8eaa="" class="question-card"><!---->
<div data-v-1ece8eaa="" class="question-text-wrapper"><!---->
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<div data-v-1ece8eaa="" class="question-title">
<p data-v-1ece8eaa="" class="editable-input view">Do you have any additional comments or questions for us?</p>
</div>
<p data-v-1ece8eaa="" placeholder="Description" class="question-description editable-input view"> Feel free to share your thoughts or ask any questions. </p>
</div>
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<div data-v-37898f8f="" class="question-body question-wrapper" data-order="9" setappvuevariable="function () { [native code] }" data-v-1ece8eaa="">
<div data-v-e95a78e6="" class="input-field i-text textarea prepend-icon success-input-wrapper">
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<i data-v-08209afc="" data-v-e95a78e6="" class="icon-left i-icon"><svg xmlns="http://www.w3.org/2000/svg" preserveAspectRatio="xMidYMid meet" viewBox="0 0 448 512"><path d="M280 48H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h272a8 8 0 0 0 8-8V56a8 8 0 0 0-8-8zm160 384H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h432a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8zM280 304H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h272a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8zm160-128H8a8 8 0 0 0-8 8v16a8 8 0 0 0 8 8h432a8 8 0 0 0 8-8v-16a8 8 0 0 0-8-8z"></path></svg></i>
<textarea data-v-e95a78e6="" id="i-text-10" class="f-input"></textarea> <!----> <!----> <!----> <!----></div>
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<h3>Thank you<strong>! </strong>We're excited to have you on board as we create a pioneering space in Singapore.</h3>
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text-photo text-video text-bold text-italic text-underline text-strike text-code text-paragraph text-ol text-quote apple stackoverflow text-hr text-undo text-redo text-font text-fontcolor text-link Save as a draft and continue later GET THE LINK WE'D LIKE TO INVITE YOU TO SHAPE THE FUTURE OF PATIENT CARE. Name Number for WhatsApp. We will use it for easier communication for upcoming events. (Optional but recommended for seamless updates.) Email Stay updated with event invitations and our latest news. Job Title Knowing your role helps us tailor our content and events to your interests. Organization/Company Tell us where you work so we can understand your background better. LinkedIn Profile URL Connect with us and other community members on LinkedIn. What upcoming date would work for you? Select the dates you’re available to ensure your spot at our exclusive events. Thursday, 18 July - Building Bridges: Integrating Technology and Evidence for Advancing Lung Cancer Care Wednesday, 24 July - Innovative Pathways: Enhancing Patient Journeys with Cutting-Edge Technology Thursday, 1 August - From Data to Discovery: Harnessing Genomic Data for Precision Medicine (Breast Cancer) Wednesday, 7 August - AI-Powered Care: Transforming Patient Outcomes through Intelligent Solutions Thursday, 15 August - Decentralized Trials: Leveraging Telehealth for Inclusive Patient Recruitment Do you have any specific topics you’d like to see covered in our events? Your input helps us plan content that matters to you. Do you have any additional comments or questions for us? Feel free to share your thoughts or ask any questions. THANK YOU! WE'RE EXCITED TO HAVE YOU ON BOARD AS WE CREATE A PIONEERING SPACE IN SINGAPORE. I agree to terms & conditions . Submit Made with