Puget Sound Volunteer Interest Form

Thank you for your interest in volunteering for the American Heart Association! We depend on the time and talent of volunteers to help us create a healthier world, free of heart disease and stroke, and we can’t thank you enough for representing our mission out in the community. Please complete this interest form and we will contact you with next steps or if we require additional details.

First and Last Name

First NameLast Name

Email Address

example@example.com

Phone Number

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

Zip Code

Are you 18 years of age or older?

If you have personal experience with heart disease, stroke, or risk factors like high blood pressure, high cholesterol or diabetes, do you have an interest in sharing that story?

What type of volunteering interests you? Select all that apply.

Which events are you interested in supporting?

What types of tasks would you like to assist with at the event(s)?

Do you have clinical experience?

Please briefly describe your clinical experience:

How often would you like to volunteer with us?

Please list any other languages you speak other than English:

Is there anything else you would like for us to know about you?

Email Newsletter Opt-In

Race/ethnicity (select all that apply)

Are you a heart disease or stroke survivor, family member or caregiver of someone impacted by heart disease, stroke or a risk factor like high blood pressure, diabetes or high cholesterol?

If you answered yes to the last question, can you tell us briefly about your experience with heart disease/stroke/etc?

If you have personal experience with heart disease, do you have an interest in becoming more involved in sharing your story and engaging your network via social media?

Do you have a specific passion or interest that relates to cardiovascular health? (i.e., heart attack, stroke, high blood pressure/hypertension, congenital heart disease, maternal health, women’s health, health equity, etc.)

Please check (all that apply to you) volunteer events and activities you would prefer to be involved with at AHA:

Please elaborate on any skill you checked in the last question.

If you have clinical or medical experience, please let us know the name of your employer and briefly describe your clinical experience.

How did you hear about the American Heart Association? Please include past volunteer involvement with AHA, if any.

Is there anything else we should know about you that would help us connect you to opportunities that are meaningful to you, for example scheduling preferences or virtual only opportunities?

American Heart Association Puget Sound Volunteer Interest Form