• Apply

 

You could be one of next year's winners!

You can either e-mail your completed application form to us at [email protected] or upload it using the form below.

Download the application form here 

 

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Medical Information Request

Please note that by submitting this form you authorize Novartis Pharma AG, as well as affiliate entities and partners, to use your name and center/hospital/practice affiliation name in regard to accessing your application and using the provided information and multimedia materials when publicizing the winners of the XOVA program. This includes, but is not limited to, use in press materials, promotional materials, at promotional events, Novartis Pharma AG-owned websites, and other media forms, on a worldwide basis in perpetuity. Your information and any multimedia materials

provided will not be used if your project is not selected as a XOVA winner.

Data Privacy Statement: When you apply for the XOVA, you accept that the Sponsors (Novartis Pharma AG, located in Basel Switzerland), AMP Health GmbH (headquartered in Zürich, Switzerland and managers of the XOVA program), and the XOVA judging panel of ophthalmologists will use the information you provide on your application form to select the XOVA winners, and to contact successful applicants. Once the program is concluded for a particular year, if you have not been selected, your personal information and any multimedia materials that you have provided will be deleted. By submitting this application, you permit Novartis Pharma AG, AMP Health GmbH and the judging faculty to use your personal information as described, and to transfer the information between themselves as required.

We would like to store your email address in order to keep you up to date with any XOVA program news, such as notifying you when the award opens for applications each year. Your email address will not be used for any other purposes.

 

 

 

Data Privacy Statement: When you apply to XOVA, you accept that the Sponsors (Novartis Pharma AG, located in Basel Switzerland), AMP Health located in Zürich, Switzerland (who manage the XOVA program), and the XOVA judging faculty (ophthalmology experts located in countries around the world) will use the information you provide on your application to select the XOVA winners, and to contact successful applicants. Once the program is concluded for a particular year, if you have not been selected, your personal information will be deleted. By submitting this application you permit Novartis Pharma AG, AMP Health, and the judging faculty to use your personal information as described, and to transfer the information between themselves as required for the purposes of the program in accordance with the Privacy Policy.