Heartsaver Hero Award

Tell Us Your Heartsaver Hero Story!

Today, many Americans feel helpless to act during an emergency because they do not know how to administer CPR or they are afraid of hurting the victim. We want to recognize heroes such as bystanders, colleagues, nurses, and EMS providers who have stepped in to save a life. Thank you for performing the heroic act of CPR, a critical link in our chain of survival. You have not only helped save a life within your community, but you are also partnering with the American Heart Association to improve the survival rate of citizens who receive CPR from a bystander.

Please fill out the Heartsaver Hero form so that the rescuer can be recognized and the AHA can keep a record of survivor stories and CPR use. Please allow up to 2-3 weeks for processing and certificates will be mailed to the address provided. Please contact HeartsaverHero@heart.org with questions.

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. We are also seeking stories of nurses and EMS providers who can we recognize during Nurses Week and EMS Week. You will be contacted if we use your story.

We are happy to honor anyone who has assisted in any part of our chain of survival, regardless of training or outcome. Learn more about Heartsaver Heroes.
Submitter's Name (required)*

Submitter First NameSubmitter Last Name
Submitter's Email Address
example@example.com
Are you an AHA Employee?

YesNo
STEP 1: RESCUER(S) INFORMATION

Type the FIRST and LAST name of the rescuer into the below box.

If you are including more than one rescuer, simply click the green + button and add the FIRST and LAST name of each additional rescuer.

Once all FIRST and LAST names have been added, please continue with the form, answering all subsequent questions.
Please provide rescuer's FIRST and LAST names. Click the Green + button to add additional rescuers.*
Were the Rescuers trained through the AHA?

YesNoUnknown
Rescuer(s) status during incident?

Bystander/StrangerTeacher/Student/School StaffEMS/ParamedicPolice/FirefighterFamily MemberDoctor/Nurse/Hospital WorkerColleagueTelecommunicatorOther
STEP 2: SURVIVOR INFORMATION
(Survivor Inforomation isn’t required but helps ongoing learning about cardiac events)
Survivor Full Name

Survivor First NameSurvivor Last Name
Age at time of incident
Gender
Ethnicity
STEP 3: INCEDENT INFORMATION
Type of incident

Cardiac Arrest/Heart AttackStrokeDrowningChokingOther
Brief description of incident
Location of incident
AHA Involvement since incident
Would you or rescuers like to be contacted or spotlighted? (required)*

YesNo
STEP 4: SHIPPING INFORMATION
(Address where you would like the Heartsaver Hero Award mailed. We cannot ship to a PO Box or International)
Addressee Full Name (required)*

Recipient First NameRecipient Last Name
Recipient E-mail (required)*
example@example.com
Recipient Phone Number (required)*
Please enter a valid phone number.
Certificate Shipping Address (required)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: