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Membership for Patients and Families

Please provide the following information to become a member of the Adult Congenital Heart Association. Membership for patients and family members is FREE.

After completing the form, you will receive our bimonthly e-newsletter, Heart Happenings; information about webinars, events and advocacy efforts; and an email linking you to pertinent ACHA materials. In addition, upon becoming a member, you may also register for our Discussion Forum, a place for registered ACHA members to discuss issues with other members of the ACHA community and provide and receive support.

Please read about ACHA's Patient Health Promise by clicking here.

Your Information

First Name *

Last Name *

Email Address *

Street Address *

Street Address (2)

City *

ZIP / Post Code *

Country *

Phone Number *

Birth Date *

Options

Let us know your communication preferences:

I would like to be contacted by a Heart to Heart Peer Mentor

I DO NOT wish to receive communication from ACHA through email

I DO NOT wish to receive communication from ACHA through postal mail

We want to hear from our members! Please provide your suggestions, ideas, webinar topics, etc. Any questions?