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

Name

First Name*

Last Name*

Profession*

Specialty*

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)*

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*

Email

E-mail*

Confirm E-mail*

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

User Agreement

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

By clicking below I acknowledge that I am enrolling in Go Red For Women, a program for women created by the American Heart Association, Inc. ("AHA"). 
I am engaging in the Go Red For Women/AHA Program voluntarily and for my own personal reasons. I understand that it is my responsibility to consult with a physician regarding heart disease.
 
The Go Red For Women/AHA programs I am enrolling in may advocate or involve physical activity such as exercise. Such physical activity is a potentially hazardous activity that may involve certain risks. By participating in AHA programs, I assume all associated risks. It is my responsibility to consult with a physician to determine my ability to engage in any and all activities associated with the Go Red For Women/AHA Programs. It is also my responsibility to use equipment, clothing, and technique that are appropriate for the activities related to the Go Red For Women/AHA Programs. I am solely responsible for my own safety.
 
I agree to not sue, and to release, indemnify and hold harmless, Go Red For Women and the AHA, its affiliates, officers, directors, volunteers and employees, and all sponsors of the AHA programs sponsors and the agents of such sponsors, from any and all liability, claims, demands, and causes of action whatsoever, arising out of my participation in the Go Red For Women/AHA programs, whether arising from the negligence of any of the above parties or from any other cause. The foregoing release, indemnification, and hold harmless shall be as broad and inclusive as is permitted by the state in which I live.
 
I consent to the aggregation of my non-identifying information with like information from other people, and I consent to the release of such aggregated information to other parties, including but not limited to the sponsors of Go Red For Women/AHA. I authorize Go Red For Women and the AHA to mail me information about the AHA Programs or about other AHA offerings.
 
I acknowledge and agree that the AHA may discontinue certain AHA programs without notice to me and that I shall have no continuing rights in the AHA programs upon such termination.
 
I assert that I am the person about whom the information I am providing relates.
 
If any portion of this agreement is held invalid, the balance shall continue in full force and effect.
 
If you do not wish to receive free educational materials from this program, you may delete your name and e-mail from our mailing list by e-mailing email@heart.org. Or you may write to us with your name, address and e-mail to the address below. 
Note: Please make sure your name and address match the information that you provided during registration.
 
Go Red For Women Membership 
American Heart Association 
7272 Greenville Avenue 
Dallas, TX 75231
 
We apologize for any inconvenience if you are sent an e-mail in error.

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