Innovation Services Request

Select your organization/affiliation.

UNC-Chapel HillCompany or Other Organization External to UNC-Chapel Hill (includes UNC Health)

First Name

Last Name

Email Address

Phone Number

Company/University Information

Name of Company (if formed) or Affiliated University:

If University, please specify School or Department

Street Address

City

State

Zip Code

North Carolina County

Requests from outside of UNC-Chapel Hill are part of our Innovation Services Recharge Center option and may have fees attached to services.

UNC-Chapel Hill Contact Information

PID

UNC-Chapel Hill Affiliation (Alumni please enter your current company/organization):

FacultyUndergraduate StudentGraduate StudentStaff or Post Doc

UNC-Chapel Hill School or College

Department in UNC College of Arts & Sciences

Other UNC School, College, Department

Request Details: Service Request and Referral

Service Group Requested:

Patent Landscape and Market ResearchVenture ServicesData or Database ConsultingNot sure. We should discuss.

If you need Design Thinking Services, please use this form.

Briefly tell us about your project, business, or innovation; what services you are seeking; and your timeline. This will also help us direct your referral for other services.

What are a couple of good days/times to arrange a meeting in the next two weeks? A member of our team will follow-up with a calendar invitation

Referral Details (if applicable)

Referred by:

If other, please specify:

255 Characters Max

Please specify contact person from referring program, so we can thank them:

Program applying to (validation)

Innovation Services Recharge

Contact Information