First Name *
Last Name *
Name of Company / Institution *
Company / Institution web address (if any)
Company / Institution Address
Offered Opportunity *
1. Nature of Opportunity
2. Development Phase
3. Therapy Area
Central Nervous System Disorders
Critical Care / ICU setting
Other (please specify below)
4. Is there Intellectual Property protection available or filed for the opportunity? *
5. If so, what kind? *
Composition of matter
6. What markets are covered by the patents / protection?
7. Is clinical data available? *
If so, at what phase? *
8. What other data is available?
9. How widely is the opportunity available for licensing (geographies, indications)? *
10. Please describe for us what the benefits of the opportunity are compared to the conventional therapies. Please also describe the proposed structure for the collaboration, if Orion were to pursue it further.