Get Your Local Info

Find out what is happening at your local American Heart area

Stock Image Heart Walk   Stock Image Women   Stock Image Father and Daughter  

Have you or someone you care about suffered from heart disease or stroke? Give hope to others by sharing your story.

At the American Heart Association/American Stroke Association, we often get requests from the media, companies, schools, and others for individuals to share their story.

If your story fits a request made to us, we will contact you and ask for your permission to use your story. We do not share this information without prior permission from you.

Thank you in advance for your help as we work together in the fight against heart disease and stroke.

Please note: All fields are required.

Today's date:
Name:
Address (Street, City, Zip):
Email:
Phone number:
Preferred method of contact:
Age:
Gender:
Ethnicity:
Were you or your loved one saved because of CPR?Yes No
Have you or your loved one suffered from heart disease or stroke as a result of smoking?Yes No
Would you be interested in sharing your personal story as a spokesperson for the AHA?Yes No
Select the option that best identifies your story:Heart Stroke Lifestyle Change Other
Date and location of cardiac incident:

Please share your story in 1,000 words or less. (Tip: It may help to write your story in a Word document and paste it in this field.)

 
 
 

Acceptance of Terms
I have read and accept the terms of this for as outlined in the attached document.

Please disregard the fields in the attached document that require you to fill out information and provide your electronic signature below to acknowledge that you have read the document and you understand and agree.