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Synergy-innovations
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Intake form
Help us serve you better
Name
*
Email address
*
What type of project are you interested in?
Please select at least one option.
Healthcare Innovation
Sustainable Solutions
Digital Transformation
AI & Machine Learning
Blockchain Technology
Environmental Conservation
Social Justice Initiatives
Urban Development
Smart City Solutions
What is your preferred method of contact?
Select
Email
Phone
In-Person Meeting
Video Conference
What industry does your organization belong to?
Please select at least one option.
Healthcare
Technology
Education
Finance
Retail
Manufacturing
Non-Profit
Government
Energy
What are your main goals for this collaboration?
How did you hear about us?
Please select at least one option.
Social Media
Word of Mouth
Search Engine
Networking Event
Conference
What is your project timeline?
Select
Immediate
1-3 Months
3-6 Months
6-12 Months
Longer than 12 Months
What is your budget range for this project?
Select
Under $5,000
$5,000 - $10,000
$10,000 - $50,000
$50,000 - $100,000
Over $100,000
Would you like to schedule a consultation?
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Yes
No
Additional questions or comments
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