Application Form - Next Health by Altibbi

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Let’s start with basic information

Please provide accurate details.

Name*

Last Name*

Email*

Phone Number*

Primary contact role/title*

Company Name*

Company website / product URL*

Company headquarters location (city, country)*

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Team & Founders

Tell us about the founding team and key members. Include backgrounds, roles, LinkedIn profiles, and equity breakdown.

Founders and key team members (names, roles, backgrounds)*

How many companies have you founded before?*

This is my first ventureSecond ventureI have worked on at least 3 ventures

Number of full-time team members*

LinkedIn profile links for founders and key team members*

Equity breakdown among founders and investors*

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Product & Market

Describe the problem you are solving, your solution, and what makes it unique. Tell us about your target market, customers, and competitors.

What problem are you solving?*

Describe your product or solution.*

What makes your product unique or different from existing solutions?*

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Integration & Business Model

Tell us which Altibbi modules you plan to use and how you will integrate them. Describe your business model and revenue approach.

What is your revenue model (e.g., subscription, transaction fees, licensing, B2B contracts, etc.)?*

Which Altibbi products do you plan to integrate?*Medical contentTelehealth (doctor appointments)AI health assistant (Sina)Other

How do you plan to integrate Altibbi's infrastructure into your product or service?*

Are you currently integrating AI into your product or operations? If yes, please describe how AI is being used and its role in enhancing your solution.*

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Motivation & Fit

Tell us why this program is a good fit for you now and what you hope to achieve.

Why is this program a good fit for you at this stage of your company's development?*

What do you hope to achieve during the program?*

Are you able to commit at least 10–15 hours per week and deliver integration milestones?*

YesNo

Step 6

Next Health by Altibbi

Let’s start with basic information

Team & Founders

Stage & Traction

Product & Market

Integration & Business Model

Motivation & Fit