Using the form below, please provide us with information about your organization and what kind of assistance you are seeking from PHMI. It is critical that you provide as much information as possible using the form, in order to help accelerate the process of determining how we can help you meet your needs.

IMPORTANT:

  • Prospective PHMI clients must have sufficient resources, including adequate funding, to carry on a collaborative relationship. PHMI enters into agreements based on a fee-for-service model whereby PHMI provides mutually agreed upon deliverables within a defined timeline.
  • PHMI does NOT provide Harvard branding and we do NOT award degrees or engage in client relationships to develop joint degree-granting programs.
  • Prospective clients who submit information via the form below will receive a PHMI Fact Sheet and a background document explaining the process by which PHMI considers potential engagements and develops relationships with clients. These materials should not be construed as binding in any way, or representative of PHMI's intentions to go forward with a contractual relationship.

Visit the "How We Work" page on our website to learn more about how PHMI develops new client relationships.


Contact Information
First name*
Last name*
Position/Title
Organization name*
Organization type*
If other:
Country*
City*
Email address*
Phone number*
Organization website
How did you hear about PHMI?*
If other:
Project/Program Information
Which best describes your project?*
If other:
Project Country*
Project City
 

Please describe your organization's project or program using the text box below, specifically addressing the manner in which you would like PHMI to assist you. Please also provide information regarding the current status of the project or program, and your desired timeframe for PHMI's involvement.*

Please Note: Prospective clients must demonstrate a commitment to good business practices and have adequate funding to carry on a collaborative relationship.
Do you have funds available?*
Yes   No. If not, when do you expect to receive funding?
 
 
Is your funding source based in the United States?*
Yes   No.