Melanin & Medicine Healthcare Consulting Intake

Thanks so much for connecting with us!

Please complete the form below so we can learn about how we can best support your organization.

We advise you to share as much detail as possible so we can have a very clear understanding of your needs and goals and whether we will be able to assist.

*Please note that we only provide our consulting services to organizations that are making at least $1 million in annual revenue

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Please share in detail about your needs regarding funding or scaling your healthcare organization

What is your greatest challenge in funding and/or scaling your organization?? *

Which service are you interested in learning more about?

Why was now the right time to connect? What is the ideal outcome you want to achieve by working with our company? *

What is the ANNUAL revenue of your organization?

Please share how you learned about our services.

If you were referred by someone, who is this amazing person that we need to send a thank you to?

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