Affiliation Procedure

Affiliating to the Global Heart Hub is just a two step process:

Step 1: Complete the Affiliation Form below

Step 2: If you meet the criteria, you will be contacted by GHH and asked to sign the Terms of Engagement.

Optional: If necessary, a virtual meeting or request for further documentation may take place to clarify further issues. However, this is not mandatory if the information provided is sufficient and clear.

Affiliation form for organisations

Type of Affiliation you are applying for:

Patient organisationAssociate organisation

¹ We consider a Patient Organisation to be any group of individuals who have come together to highlight the needs of heart patients and their carers. Organisations must be patient-led with leadership and membership predominantly comprised of those living with a cardiovascular condition, carers or patient advocates.

² We consider an Associate Organisation to be an organisation or group who are predominantly focused on the needs and issues relating to heart patients and their carers. Associate Organisations are viewed as general affiliates of the Global Heart Hub and do not participate on any of our patient councils. However, they have opportunities for engagement with our patient councils as well as being kept informed of all Global Heart Hub Activities.

If you wish to apply as an individual patient advocate, please complete this form instead.

GHH Patient Councils or Working Groups

If you are a patient organisation and would like to join GHH Patient Councils or Working Groups, please select which one(s) you would like to join if your affiliation is approved (you can select more than one): *
Heart Failure Patient CouncilHeart Valve Disease Patient CouncilCardiomyopathy (and related conditions) Patient CouncilCardio Diabetes Working GroupWomen and Heart Disease Working GroupAtherosclerotic Cardiovascular Disease (ASCVD) Working GroupNone

Your Organisation details:

Full name of the organisation (in local language): *

Full name of the organisation (in English): *

Brief description of the organisation (mission and objectives).
This description will be used on the Global Heart Hub website once your application is approved: *

Is your organisation a registered non-profit, charitable organisation or social enterprise? *

Is your organisation registered / established as a patient organisation? *

Which disease(s) does your organisation deal with (please specify)? *

How can your organisation reach best be described: *
LocalNationalRegionalInternational

Is your organisation patient or patient representative led (with patients / representatives on the
board)? *

Does your organisation have a patient-centred mission? *

Does your organisation have medical/scientific advisors? *

Please provide name and affiliation: *

Does your organisation receive funding from more than one sponsor? *

Existing memberships:

Does your organisation's membership consist predominantly of patients? *

How many patients/families/caregivers does your organisation represent or have registered with
it? *

Is your organisation already a member or affiliate of other alliances or coalitions? *

Please list: *

Your organisation contact information:

Prefix of Main Contact for your organisation: *

Name of Main Contact for your organisation: *

Email address of Main Contact for your organisation: *

Mobile number of Main Contact for your organisation: *

Location (Country) of your organisation: *

Full address of your organisation:

Telephone number/ mobile phone (including country code):

Languages spoken: *

Link to your organisation's website:

Link(s) to your organisation's social media pages:

Your organisation's logo:

Please upload your organisation's logo:

I have read and agree with GHH Terms of Use and Privacy Policy

I agree that the Global Heart Hub stores/retains the information provided in this application form in the GHH database and share it internally as necessary for affiliation-related purposes.

I agree to the Global Heart Hub publishing public information about my organisation on the GHH website here.

I declare that all the information provided above is correct and accurate.

If you have any questions about your application or the storage of your data, please contact us at info@globalhearthub.org