Stay connected to your health form

Stay connected to your health.

Sign up to receive health education, screening reminders, and follow-up from your community health worker. Free. No spam. Unsubscribe anytime.

Your information

All fields marked with * are required. Your information is kept confidential.

First name*

Last name*

Phone number*

We use this to send reminders and follow-up.

Email address

Optional, but helpful for written follow-up.

Date of birth*

ZIP code*

Preferred language*

We'd like to send you helpful text messages — screening reminders, health tips, and follow-up from your community health worker.

Yes, text me updates from Heart of a Giant Foundation. I can reply STOP any time to opt out, or HELP for help.

The fine print