Form D · Other Technology

Form Health, Inc.

Boston, MA · CIK 0001779388

Offering snapshot reported Apr 15, 2025 · SEC filing

Reported sold
$43M
Offering amount: $43M
Investors reported
10
Form D · investor count
Minimum accepted
$0
Reported outside-investor minimum
First sale
Jun 12, 2024
As reported in this filing

Fundraising history

Reported sold
Reported amount sold by Form D filing date$0$21.5M$43MJun 26, 2024: $32,999,982.00Jun 26, 2024Apr 15, 2025: $42,985,000.00Apr 15, 2025

Dates are filing dates, not cash receipt dates. Decreases are reported revisions, not evidence of withdrawals. Separate offering histories are not added together.

What changed?

Latest filing versus its linked predecessor, where available.

  • Reported sold$32,999,982 → $42,985,000
  • Reported investors7 → 10

Filing history

Scroll to see all columns →

FiledFiling typeReported soldChange vs linked filingInvestorsSource
Apr 15, 2025Amendment$42,985,000$9,985,018vs Jun 26, 202410SEC filing
Jun 26, 2024Initial$32,999,982No comparison7SEC filing
Nov 6, 2023Initial$6,700,000No comparison3SEC filing
Jan 13, 2023Amendment$22,884,578$3,200,027vs Oct 14, 202212SEC filing
Oct 14, 2022Amendment$19,684,551$8,604,981vs Apr 28, 20219SEC filing
Apr 28, 2021Initial$11,079,570No comparison5SEC filing
Jun 10, 2019Initial$3,434,994No comparison9SEC filing

Offering details

Securities
Equity, Option to acquire
Exemptions
06b
Duration over one year
No
Business combination
No
Sales commissions
$0
Finders' fees
$0
Form D file number
021-516986
Amounts include conversion of outstanding convertible securities.

Source: Form D, filed Apr 15, 2025. Minimum accepted may differ from a standard advertised minimum.

Fund connections

No confirmed ADV fund connection is available for this issuer.

People & organizations

Current and past Form D appearances. These existing records do not establish a person's current role or uniquely identify them across issuers.

People and organizations reported in Form D filings
NameReported role
Juliette Bolea Director
Latif Peracha Director
Evan Richardson Director, Executive, Promoter

Issuer details

Industry: Other Technology (See others in industry)

Address:
109 State Street 5th Floor
Boston, MA, 02109