Thank you for taking the time to participate in this important research, that will help people like you experiencing heart failure and heart diseases achieve better health outcomes in future.

This study is being undertaken in collaboration with Hearts4heart, the only Australian patient led charity supporting, educating and advocating for people living with heart disease hearts4heart.org.au AND Global Heart Hub, an alliance of patient organisations dedicated to people living with heart disease globalhearthub.org

Before you can access the research study portal, there are some initial questions to establish if you are eligible to participate. This data will be used only to undergo this pre-screening questionnaire, and then deleted once the study period is completed (31 May 2024).

If you consent to be followed up by Hearts4heart, we will contact you to connect you with our network and give you access to patient information, education and resources for managing Heart Failure.

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* 1. What is your full name (first name / last name)?

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* 2. What is your contact email address?

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* 3. Have you personally ever been diagnosed (by a healthcare professional) with chronic heart failure? (Also known as congestive heart failure)?

Heart failure happens when the heart isn’t able to pump enough blood to the body, or when your heart cannot fill properly with blood. It can be caused by multiple reasons, and is usually diagnosed by tests done by a health care professional in hospital.

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* 5. Do you consent for hearts4heart to follow up with you?
We offer services and information and education for patients with heart diseases in Australia, that may be useful to managing your condition

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* 6. Is there anything else you would like to tell us?

E.g. Alternate contact email or a telephone number for follow up

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* 7. Thank you for your time. If you are eligible for the patient research, we will send you a further email with instructions to participate. If you have consented for hearts4heart to follow up, we will be in touch with you soon.

Best wishes,

On behalf of Tanya Hall, CEO & Founder
hearts4heart

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