Strategic Relationship Form

Step 1/3 : TELL US ABOUT YOUR COMPANY

This form allows Revera to review companies on a quarterly basis. We engage with companies if we are looking to fill a specific need or pilot potential products/services. If you do not hear from us, we do not have a need at this time, however, we will keep your company on file for future needs.

Submission Deadlines
Q1 - March 31
Q2 - June 30
Q3 - September 30
Q4 - December 31

1. What is the name of your company? (Maximum character count of 100) *

2. Describe your company in one line. (Maximum character count of 200) *

3. What is your website address?

4. Where is your company’s headquarter located? (Maximum character count of 100) *

5. How old is your company? *

6. What is your ownership structure? *

7. How many employees are there in your company? (Maximum character count of 100) *

8. List your top 3 competitors. (Maximum character count of 200) *

9. List your top 3 clients within the seniors accommodations, care and services sector. (Maximum character count of 200) *

10. What stage best describes your company’s current product development stage? *

11. If you would like to upload your non-confidential pitch deck, you may do so here. We accept PDF, Word and PowerPoint formats. Please note that the maximum file size is 25mb.