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Disclosure Form

MMC/MMCV

Invention Disclosure Form


All information and data disclosed to MMC/MMCV in this document is considered proprietary and will be held confidential. This form is a way to let us know you have innovation or technology and give us information about it.


This form is a significant first step in the process that could lead to the broad dissemination and commercialization of inventions created by MMC faculty, staff, students and alumni. This form also serves as an institutional record which provides essential information for identifying intellectual property, including inventions, technological innovations, discoveries, methods, processes, and other patentable, trademarkable or copyrightable works. As you are completing the form, please provide as much detail as possible.

 

The purpose of this form is to provide a written, dated notice of your invention disclosure.  A disclosure is necessary to enable the College and MMCV to comply with most industry contractual requirements, as well as the requirements of the U.S. Federal Government laws and regulations as they are applied to college grants and contracts.

 

MMCV will use the information contained within this form to assess the opportunities available to protect the invention (e.g., through patenting, copyright, trademark, etc.) as well as to assess the commercial and market potential of the invention disclosed.

 

An invention disclosure should be completed when something new and useful has been conceived or developed or when unusual, unexpected, or unobvious research results have been achieved and can be utilized.

 

After receipt of the completed disclosure form the researchers may be asked to provide reasonable assistance (e.g., equity review, participate in patent and literature searches, review patent drafts, and assist in discussions with industry contacts).

 

The person completing this disclosure form is responsible for providing a complete copy to all those individuals listed in the inventor section.


Date
Month
Day
Year

(3-5 sentences in plain language)

Include novel aspects, functionality, and how it works: What problem does it solve?

Please describe at any stage of development (e.g. existing commercial products or services, etc) that your invention may compete with.

Is this invention disclosure related to any earlier invention disclosure here or at another institution?

Has any aspect of this innovation been publicly disclosed?

Do you have any plans to make a public disclosure in the next 30 days?

Has the research that led to the innovation been sponsored or funded by industry, or funded by a grant(s) from a government agency or private foundation?

In this research did you use any materials or confidential information provided by another institution or company?

If you do not currently have funding, are you actively seeking it?

  • Name, Department, Email, Contribution %

  • List non-Meharry Medical College inventors (if applicable)

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Copyright: © 2025 by Meharry Medical College Ventures, Inc.

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