Welcome to the JP Centre for Health Systems Learning + Innovation (JP Centre) Idea Intake Form

Thank you for taking the time to share your idea or project with us. The purpose of this form is to gather information about your idea so that our team can review, assess, and connect you with the appropriate resources and supports.

Idea-Holder Information

Submitter Name

Submitter Email

Contact Location (City)

Organization/Company Name

How would you describe yourself?

What is your primary role as it relates to this idea?

Please select all roles you identify with.

Your role beyond the scope of this idea.

Secondary Contact (if applicable)

Contact Name

Email Address

Role in relation to this project

Idea Summary

Idea Full Title

Idea Short Title

Problem Statement

Solution

Impact/Benefits

Attachment(s) (file upload)

Please upload any relevant project documentation you think may help us understand this idea

What JP Centre Support(s) are you interested in?

Please note: JP Centre does do not provide direct funding of ideas at this time, rather, we help connect to funding opportunities.

How Did You Hear About Us?

(Other) Please specify

Additional Information:

Anything else you would like to share related to your idea or desired supports?

Send a copy to my email address.