Registration

Thank you for choosing to become a Go Red For Women Champion!

Joining Go Red For Women Healthcare Professionals is a simple, powerful way to promote awareness of heart disease in women while keeping up with the latest science from the American Heart Association. Your involvement will help you link the women who visit your office with important information about protecting their hearts and simple steps to reduce their risks.

By signing up, you'll receive these Go Red For Women Professionals benefits:


  • A red dress pin you can wear proudly to show your choice to beat heart disease and stroke.
  • A monthly e-newsletter filled with science news, continuing education opportunities, patient education tools and materials, events and programs, and more.

To become a Go Red For Women Champion, just fill out the brief registration form below. You'll be all set to get involved and inspire other women to keep their hearts healthy.

(*) Required Fields hr

Name

First Name*
Last Name*

Profession*
Specialty*
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Username/Password

Your username and password are your key to the American Heart Association program registrations.

Username*
Password (Minimum of 6 characters)*
Verify Password (Minimum of 6 characters)*
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Security Question/Answer

Security Question must not exceed 150 characters. You will be able to access your account using the correct answer to your Security Question if you forget your Username or Password.

Security Question*
Security Answer*
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Email

E-mail*
Confirm E-mail*
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Address: Order your free red dress pin

Wearing the Go Red For Women red dress pin is a great way to remind your parents and coworkers to love their hearts every day. Order your free red dress pin now!

Address 1
Address 2

City
State/Province

ZIP/Postal Code*
Address Type Home Address
Office Address
Both

If you have a special promotional code, please enter it here:


Your order should arrive in approximately 2-4 weeks
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User Agreement

Before you submit your registration, please read and agree to the terms below.

* I have read, understand, and agree to the terms of this agreement.


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