Please indicate below the AHA Advocacy Alliances in which you would like to participate. Alliances activities will include working with members of Congress to highlight issues, special briefing calls and e-mails to keep members up to date on pertinent developments; special breakout sessions at AHA advocacy days, direct member outreach, and dedicated web-presences at www.aha.org.

If others on your team would like to participate, please ask them to complete a separate form.

* 1. Contact Information:
    All fields in this section are required.

* 2. AHA Advocacy Alliances:
     Please select the group, or groups, you wish to join.

* 3. Comments or questions:

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