Central Valley 209 HW Lifestyle Change Award 209 Heart Walk

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 St. Joseph’s Medical Center wants 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 Change Award can be submitted by friends, co-workers or relatives, and individuals can nominate themselves. Winners will be chosen by a volunteer committee.

Please submit this form by Monday, October 2, 2023.

Your Name:*

First NameLast Name

Your Phone Number:*

Please enter a valid phone number.Format: (000) 000-0000.

Your Email Address:*

example@example.com

What is your relationship to the nominee?*

Nominee Name*

First NameLast Name

Nominee Company / Worksite*

Nominee Email Address*

example@example.com

Nominee Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

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

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.

Lifestyle Change Award Nomination Form

Your Information

Nominee Information