Stroke Simulation Event - Registration Form

Stroke Simulation Event - Registration Form
On behalf of the American Stroke Association, thank you in advance for hosting a stroke simulation event to improve systems of care and help patients obtain the best treatment possible. Please register your event using the form below. Participating hospitals will receive acknowledgement on StrokeAssociation.org and a certificate of recognition.
Hospital Name (required)*
Event Date (required)*

MonthDayYear
Event Time (required)*

:HourMinutesAM/PM Option
Email (required to receive certificate)*
First Name
Last Name
City
State
Zip Code
Should be Empty: