First Name

Last Name

Phone *

Email *

City *

State *

LinkedIn Profile URL *

Company / Practice / Organization *

Current Title / Role *

What best describes your interest in Founders Friday? *

I want to attend as a guest

I am interested in sponsoring or partnering

Both

If you are a physician, what is your specialty?

Do you currently own, co-own, operate, or have decision-making authority within a healthcare business or practice? *

Yes

Partially / In transition

Are you currently exploring ways to expand revenue, add services, improve efficiency, or scale your business? *

Yes actively

Yes casually

What are you most interested in right now? (choose one or more) *

Are you currently offering or interested in offering any of the following within your practice? (choose one or more) *

What are you currently building, operating, investing in, or exploring? *

Why do you believe you would be a strong fit for Founders Friday? *

What value do you bring to a curated room of high-level healthcare leaders and operators? *

Would you be open to attending a paid Founders Friday dinner if selected? *

Yes

Maybe, depending on the event

No, I would only attend by invitation

If selected for the right room, which type of attendance would best fit you? *

Complimentary strategic guest

Paid attendee

Either depending on fit

Not sure

Would you be interested in joining virtually for select Founders Friday sessions when available? *

Yes

Maybe

Would you be open to being contacted about relevant products, services, sponsors, or strategic opportunities aligned with your interests? *

Yes

Which categories are most relevant to you right now? (choose one or more) *

Have you attended a Friends of Medicine event before? *

Yes

If yes, which event(s)?

If referral, who referred you?

Company Website *

What best describes your offering? (choose one or more) *

Who is your ideal customer within healthcare? *

What is your primary objective? *

Are you looking to: *

Sponsor a specific event

Explore a multi-event / city partnership

Still learning / open to discussion

What level of engagement are you open to? (choose one or more) *

Estimated marketing or partnership budget (optional but helpful)

Less than $5K

$5K–$10K

$10K–$25K

$25K+

Anything else we should know? *

By checking this box, I consent to receive non-marketing text messages from Friends of Medicine about application updates, event confirmations, and important information related to Founders Friday. Message frequency varies. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages from Friends of Medicine including updates about upcoming events, opportunities, and curated experiences at the phone number provided. Message frequency varies. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.