2024 Heartsaver Hero Nomination Albany NY

All fields marked with * are required and must be completed.
Tell Us Your Heartsaver Hero Story!

The MVP Arena Community Partnership and the American Heart Association are working together to improve the chance of surviving a cardiac arrest in our community. 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. But there are heroes among us, and we want to recognize them! We’re looking for bystanders, colleagues, nurses and EMS providers who have saved a life using CPR here in the Capital Region.

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 joining 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 American Heart Association can keep a record of survivor stories and CPR use.

We receive requests to use survivor stories for American Heart Association marketing purposes, as well as from the media, who may need a story involving someone of a certain gender, race, or age range. American Heart Association 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 at Nation of Lifesavers | American Heart Association
Submitter's Name (required)*

First NameLast Name
Submitter's E-mail (required)
example@example.com
Are you an American Heart Association Employee?

YesNo
Step 1: Rescuer 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 American Heart Association?

YesNoUnknown
Rescuer(s) status during incident?

Bystander/StrangerTeacher/Student/School StaffEMS/ParamedicPolice/FirefighterFamily MemberDoctor/Nurse/Hospital WorkerColleagueTelecommunicatorOther
Step 2: Survivor Information (Survivor Info isn’t required but helps ongoing learning about cardiac events)
Step 3: Incident Information
Type of incident

Cardiac ArrestHeart AttackStrokeDrowningChokingOther
Brief description of incident
Type Here
Location of incident
American Heart Association involvement since incident
Type Here
Would you or rescuers like to be contacted or spotlighted? (required) *

YesNo
Step 4: Shipping Information: Please provide an address where you would like the Heartsaver Hero Award information or award, if selected, mailed. (We can't ship to a PO Box or International)
Addressee Full Name (required)*

First NameLast Name
Recipient E-mail (required)*
Recipient Phone Number (required)*

Area CodePhone Number
Certificate Shipping Address (required) *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: