Form Health, Inc. — Form D/A
Form Health, Inc. of Boston, MA, a company, filed a Form D amendment with the SEC on 2022-10-14. The offering totals $22.0M, of which $19.7M was reported sold. Industry: Other Technology.
Offering
- Filed: 2022-10-14
- Form: D/A
- Accession: 0001779388-22-000001
- Industry: Other Technology
- Exemptions: 06b
- Total offering: $22.0M
- Amount sold: $19.7M
- Remaining: $2.3M
- Investors: 9
- Date of first sale: 2021-04-13
- Security types: equity
- Revenue range: Decline to Disclose
- SEC file number: 021-397425
Issuer
- Name: Form Health, Inc.
- CIK: 0001779388
- Entity type: Corporation
- Jurisdiction: DELAWARE
- Incorporated: 2019
- Address: 109 State Street, Boston, MA, 02109
- Phone: (617) 505-1520
Officers, directors & promoters (5)
| Name | Role | Location |
|---|
| Latif Peracha | Director | New York, NY |
| Evan Richardson | Director | Boston, MA |
| Evan Richardson | Executive Officer | Boston, MA |
| Evan Richardson | Promoter | Boston, MA |
| Juliette Bolea | Director | Brooklyn, NY |
Other filings by this issuer (6)
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