Tell Us Your Story
Please fill out this form so that the rescuer can be recognized and the AHA can keep a record of survivor stories and CPR use. Allow 7 - 10 working days for turnaround. In some cases, awards can be fulfilled more quickly. Please contact firstname.lastname@example.org with questions or rush requests.
If for any reason this form is unavailable please use this form to submit your story HeartSaver Hero Award.
Many times we receive requests to use survivor stories for AHA marketing purposes, as well as from the media, who may need a story involving someone of a certain gender, race, or age range.
AHA uses this information for future/potential marketing purposes. You will be contacted if we use your story.
Step 1: Rescuer Information
Step 2: Survivor Information (Survivor Info isn’t required but helps ongoing learning about cardiac events)
Survivor Contact Information (Survivor information isn’t required but helps ongoing learning about cardiac events)
Step 3: Nominator Shipping Information(Address where you would like the Heartsaver Hero Award mailed. We cannot ship to a PO Box)
- Should be Empty: