Email*

Password*

Repeat Password*

First Name*

Last Name*

Phone number*

Media Outlet*

Title (reporter, editor, etc)*

Media Outlet URL* Please include http://

Freelancers, please provide links (we can access) to at least 3 of your bylined health related news reports published/broadcast in the last three months as well as outlet names. If you do not have a website, type none in the text field.

You must read the AHA/ASA Embargo Policy and agree to its terms.