SaveMIHeart Involvement

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Fill out this form to become more involved with SaveMIHeart.

First Name *

Last Name *

Email Address *

Cell Phone

Address

Zip Code *

Organization (What organization do you work for or work with?)

Are you a Survivor of Cardiac Arrest?

Yes

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What are you most interested in (select all that apply)? *

Community (AED / Bystander CPR / CPR Training / School CPR / Heartsafe Communities)

911 Dispatch / Telephone CPR (Improving coverage / T-CPR Training / Legislative efforts)

EMS (Best practices for management of OHCA / quality improvement / high quality CPR / Training)

Hospital (Best practices for management of OHCA / quality improvement / Training)

Recovery (Survivor / Survival Team / Support Groups)

CARES registry (Cardiac Arrest Data collection / Improvements / Recruitment)

Research (Publish work / CARES data / community intervention)

Advocacy (Awareness / Legislative / Fundraising)

Other:

Required

List any other areas of interest or current work you are doing to improve Out of Hospital Cardiac Arrest in Michigan:

Submit

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