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Take Heart 2022

Start Date:10/2/2022

Start Time:2:00 PM CDT

Duration:180 minutes

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Take Heart is a virtual interactive educational conference that unites heart families with leading heart clinicians and healthcare systems locally and nationally to share, collaborate, and lead innovation to improve the lives of those living with or affected by pediatric heart disease.

If you're already registered for the Take Heart 2022 webcast, click below:

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Race/Ethnicity (Select all that apply)
American Indian or Alaskan Native
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Age
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OHHF Staff
Family/Friend
Hospital Referral
Sisters by Heart
CCHD
Mended Hearts
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Is this your first time attending Take Heart?
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Are you a heart family or health care professional?
Heart Family
Healthcare professional
Both
Other (please specify below)
If you answered OTHER to the question above, please specify your answer here:
If you are a healthcare professional, please specify which field you work in: (please leave blank if you are not a healthcare professional)
If you answered OTHER to the question above, please specify your answer here:
Company, Hospital or Organization Affiliation (Please leave blank if you are not a healthcare professional.)
Are there others that live in your household? (Please leave blank if you are not a heart family.)
Yes
No
How many people live in your household (including you)? (Please leave blank if you are not a heart family.)
What is your heart warrior’s name? (If multiple please separate names with a comma. Please leave blank if you are not a heart family.)
How old is your heart warrior? (Please leave blank if you are not a heart family.)
My heart warrior is deceased. (Please leave blank if you are not a heart family.)
Yes
No
What hospital did (or does) your heart warrior receive treatment? (Please leave blank if you are not a heart family.)
What is your heart warrior’s primary cardiac diagnosis? (Please leave blank if you are not a heart family.)
Would you like to receive an OHHF t-shirt for your heart warrior and/or their siblings? *T-shirts available while supplies last. (Please leave blank if you are not a heart family.)
Yes
No
If you answered yes above, how many shirts? (Please leave blank if you are not a heart family.)
Please select your child’s t-shirt size: (Please leave blank if you are not a heart family.)
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
If you need multiple shirts, please specify size and quantity below: (ex. 2 Youth M, 1 Adult L), (Please leave blank if you are not a heart family.)
Are you interested in receiving more information about free mental health services for heart families through Ollie’s Branch?
Yes
No
Comments or questions?
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