Lifestyle Award Nomination Form 2024

Healthy for Good™ is a revolutionary movement to inspire you to create lasting change in your health and your life, one small step at a time. The approach is simple: Eat smart. Add color. Move more. Be well.

Are you A Healthy for Good™ Hero? The American Heart Association along with
Desert Healthcare District & Foundation want to recognize individuals who have made or have encouraged someone to make positive changes to improve the quality of their life and health.

Nominations for the Healthy for Good™ Lifestyle Award can be submitted by friends, co-workers or relatives, and individuals can nominate themselves. Winners will be chosen by a volunteer committee.

Nominee Name*

First NameLast Name

Company/Worksite*

How may we contact the nominee if he or she is selected?

Nominee Phone *

Please enter a valid phone number.

Nominee Email*

example@example.com

Nominated By*

First NameLast Name

Nominator Phone *

Please enter a valid phone number.

Nominator Email*

example@example.com

Relationship to Nominee *

Please select one:*

This nominee has made a lifestyle changeThis nominee has maintained a healthy lifestyle change for a year or moreThis nominee has influenced others to make a lifestyle change

Has this person made changes/influenced change in one or more of the following areas?*

Eat smart – A nutrient dense, well-balanced diet (examples include: became educated on healthy eating and cooking, started preparing home cooked meals, plan and prep meals throughout the week to ensure a balanced diet)Add color – incorporate fruits and vegetables in meals (examples include: shops at local farmer’s market, joined a community garden, started their own garden, includes fruit or vegetables in every meal)Move more – Physical Activity (examples include: started an exercise program, started or joined a walking group, joined a gym)Be well - includes getting enough sleep, practicing mindfulness, managing stress, keeping mind and body fit, connecting socially, and more (examples include: add balance through meditation, yoga, prioritized self-care)

Explain what the nominee has done and how they have improved their life or the life of another.*

Describe the nominee’s biggest accomplishment, what you/they are most proud of.*

Describe something the nominee had to overcome.*

What are the nominee’s future goals and/or what are they looking forward to?*

If this nominee has maintained a lifestyle change for a year or more, describe how this was accomplished. *

Please submit nomination to: Alisha.Welchman@heart.org by November 21, 2025

Lifestyle Award Sponsor:

Desert Healthcare District & Foundation