Submit your application – Citizen CPR

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OUR MISSION
INITIATIVES
- HEARTSAFE COMMUNITY
- LIFESAVING STRATEGIES
CASSummit
AWARDS
NEWS & ARCHIVES
SUPPORT
- YOUR DONATION
- BECOME A PARTNER
DONATE NOW

Welcome >> Initiatives – HEARTSafe Community – Submit your application

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- Step 1 of 14

Who is the main point of contact for this application?

Name *

First

Last

Title

Organization *

Email *

Best Phone Number

1. A lead organization

Is a lead organization (e.g. police, fire, EMS provider, hospital or municipal office) designated to oversee and coordinate the HEARTSafe efforts? *

Yes
No

Lead organization name *

Lead organization website or address

Lead organization phone number

Enter organization roster OR upload (see below):

Upload file of roster

Click or drag a file to this area to upload.

Max. file size: 500MB

2. Plan for data collection

The community has a plan for the collection and analysis of cardiac arrest data. Enrollment in CARES is recommended - access to CARES data for your city/town or locally developed and compatible methods are acceptable. *

Yes
No

Describe method here:

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

3. Community population is trained and stays up-to-date

A minimum of 15% of the community population has been trained in the last 12 months and plans exist to train an additional 15% each year. All forms of training are acceptable including hands-only CPR, certification training at any level and views of approved ultra-brief instructional videos. *

Yes
No

Enter training numbers and any details: *

Upload any accompanying file(s), any photos, etc.

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

4. Community members are recognized for action

Laypersons who perform CPR in an effort to save a life are formally recognized for their efforts where possible and appropriate. *

Yes
No

Describe method of recognition: *

Upload any accompanying file(s), any photos, etc.

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

5. Community has implemented public awareness strategies for sudden cardiac arrest

The community has developed and implemented strategies to increase public awareness of sudden cardiac arrest and encourage bystander intervention. Examples include public demonstrations with hands-on practice, improving access to certification courses, utilization of social media and ultra-brief instructional videos, billboards, newspaper articles and other innovations *

Yes
No

Describe strategies: *

Upload any accompanying file(s), any photos, etc.

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

6. Telephone CPR (T-CPR) Program

Part A. The emergency communications center(s) have committed to providing effective T-CPR in accordance with the American Heart Association Telephone CPR Program Recommendations and Performance Measures or the equivalent. *

Yes
No

Describe Program: *

Upload any accompanying file(s), any photos, etc.

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

6. Telephone CPR (T-CPR) Program

Part B. Community leaders will engage with local and state agencies, including their local American Heart Association advocacy team, to get TCPR legislation on the priority list and support efforts to get it passed into state statute. *

Yes
No

Describe Efforts: *

Upload any accompanying file(s), any photos, etc.

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

7. Schools and city buildings have a plan

Schools and municipal buildings have effective emergency response plans for cardiac arrest. *

Yes
No

Copy/paste your ERP policy here OR (see below): *

Scan and upload your ERP policy

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

8. AEDs placed in areas of large gatherings

Permanent placement of AEDs in public or private locations where many people congregate or may be at higher risk for cardiac arrest such as shopping malls, supermarkets, theaters, health clubs, parks, recreational centers, transportation centers and other appropriate venues. AEDs placed at athletic fields, parks, beaches and public gathering spots should be accessible on a 24/7 basis whenever possible. *

Yes
No

Describe efforts: *

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

9. Participation in an AED registry

Community has established or participates in an AED registry. AED locations are mapped and integrated with your 911 system and/or local Public Safety Answering Point (PSAP). *

Yes
No

Describe registry: *

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

10. First responders are defibrillation ready

First Responder agencies (law enforcement/fire department) are defibrillation capable, with appropriate training, device maintenance plan, dispatch policies, event debriefing, and medical direction. *

Yes
No

Copy/paste your dispatch policy here OR (see below): *

Upload policy and/or any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

11. Local EMS uses "high-performance" CPR

The local Emergency Medical Services (EMS) provider practices “high-performance” CPR and has supportive protocols, technology and equipment for resuscitation and effective post-resuscitation care. *

Yes
No

Describe efforts and protocols: *

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

12. Local EMS has a cardiac arrest data process

Local EMS provider agency has a QI process for cardiac arrest data review, facilitated debriefing, access to patient outcome data and active medical direction and provides appropriate feedback for improvements to community preparedness and response. *

Yes
No

Describe process: *

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

13. Community wellness programs

The community has established secondary public health measures supporting cardiovascular wellness, such as education, prevention, and systems of care for stroke and myocardial infarction *

Yes
No

Describe measures: *

Upload any accompanying file(s)

Click or drag files to this area to upload. You can upload up to 10 files.

Max. file size: 500MB

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Initiatives - HEARTSafe Community

© 2024 CPR Foundation, Inc.

© 2024 CPR Foundation, Inc.