Awards Survey

The Heroes for Young Hearts Awards recognize individuals who demonstrate a continuous commitment in their local community to raise awareness of sudden cardiac arrest (SCA) in children and young adults through specific, impactful actions that support the Parent Heart Watch mission of protecting children and young adults from SCA and preventable sudden cardiac death. Nominees are not required to be Parent Heart Watch members.

All information provided will be reviewed by Parent Heart Watch staff and the Selection Committee.

NOMINATION GUIDELINES: Nominations must be submitted for one (1) individual per category and include specific, measurable examples of the nominee’s actions and impact between September 2025 and September 2026 in support of the Parent Heart Watch mission of protecting children and young adults from sudden cardiac arrest and preventable sudden cardiac death.

Nominations must include supporting materials such as photos and/or links to relevant news articles. Nominations without specific actions, measurable impact, and supporting materials will not be considered.

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* 1. Name of Person Completing Form

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* 2. Address

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* 3. Email

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* 4. Mobile Phone Number

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* 5. Nominee #1 - Select award category

Advocacy Champion- Medical or Allied Health Professional

Advocacy Champion - Youth (must be 20 years old or younger)

Advocacy Champion - Adult (must be 21 years old or older)

Young Survivor Champion (must be a SCA survivor, 20 years old or younger)

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* 6. Nominee #1

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* 7. Nominee #1

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* 8. Nominee #1

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* 9. Specific details of actions by Nominee #1 (i.e., research that helps advance our cause, organized 3 community heart screening events, placed 50 AEDs, trained others in CPR & AED use, etc.)

Please upload supporting information (photos, news articles, links to news articles) to our cloud server: https://parentheartwatch.egnyte.com/ul/SYOIVpGc0c

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* 10. Nominee #2 - Select award category

Advocacy Champion- Medical or Allied Health Professional

Advocacy Champion - Youth (must be 20 years old or younger)

Advocacy Champion - Adult (must be 21 years old or older)

Young Survivor Champion (must be a SCA survivor, 20 years old or younger)

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* 11. Nominee #2

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* 12. Nominee #2

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* 13. Nominee #2

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* 14. Specific details of actions by Nominee #2 (i.e., research that helps advance our cause, organized 3 community heart screening events, placed 50 AEDs, trained others in CPR & AED use, etc.)

Please upload supporting information (photos, news articles, links to news articles) to our cloud server: https://parentheartwatch.egnyte.com/ul/SYOIVpGc0c

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* 15. Nominee #3 - Select award category

Advocacy Champion- Medical or Allied Health Professional

Advocacy Champion - Youth (must be 20 years old or younger)

Advocacy Champion - Adult (must be 21 years old or older)

Young Survivor Champion (must be a SCA survivor, 20 years old or younger)

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* 16. Nominee #3

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* 17. Nominee #3

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* 18. Nominee #3

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* 19. Specific details of actions by Nominee #3 (i.e., research that helps advance our cause, organized 3 community heart screening events, placed 50 AEDs, trained others in CPR & AED use, etc.)

Please upload supporting information (photos, news articles, links to news articles) to our cloud server: https://parentheartwatch.egnyte.com/ul/SYOIVpGc0c

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* 20. Nominee #4 - Select award category

Advocacy Champion- Medical or Allied Health Professional

Advocacy Champion - Youth (must be 20 years old or younger)

Advocacy Champion - Adult (must be 21 years old or older)

Young Survivor Champion (must be a SCA survivor, 20 years old or younger)

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* 21. Nominee #4

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* 22. Nominee #4

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* 23. Nominee #4

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* 24. Specific details of actions by Nominee #4 (i.e., research that helps advance our cause, organized 3 community heart screening events, placed 50 AEDs, trained others in CPR & AED use, etc.)

Please upload supporting information (photos, news articles, links to news articles) to our cloud server: https://parentheartwatch.egnyte.com/ul/SYOIVpGc0c

Thank you for taking the time to submit your nomination(s) for our Heroes for Young Hearts awards.