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Contact Us
About
The Institute
Victor Chang
Our Scientists
Our Board
Our Structure
Annual Reports
Heart Research
COVID-19 Research
Our Laboratories
Major Discoveries
Innovation Centre
Heart Disease
Careers
Jobs Available
PhD Projects Available
PhD Scholarships
Students
What's On
Latest News
Blog
Events
Tours
Health Check Booth
Support Us
Give to our latest appeal
Donate Monthly
Leave A Bequest
Fundraise For Us
Donate in Memory or Celebration
Philanthropy and Partnerships
Merchandise
How Your Donation Helps
Contact Us
Supporter Survey
Supporter Survey
First Name
Last Name
Email
What is your age?
18-24
25 - 34
35 - 44
45 - 54
55 - 64
65 years or older
Gender
Male
Female
Which of the following research areas are of interest to you? Please select as many as you like.
Childhood heart disease
Heart attacks
Heart failure
Hypertension
Cardiomyopathy
Cardiac arrests
Stroke
Arrhythmia
Diabetes
Spontaneous coronary artery dissection (SCAD)
How has heart disease touched your life? Please tick all the boxes that apply to you.
I have a heart condition
My partner has a heart condition
My child has a heart condition
I have lost a loved one to heart disease
I have other family members living with a heart disease
I have a friend with heart disease
I have no personal connection to heart disease
Cont.
Cont.
Tell us about your hobbies and interests. Please select those that appeal to you.
Cooking
Gardening
Travelling
Health & nutrition
Reading
Exercise
Being with family & friends
Outdoor activities
Arts & crafts
If the Victor Chang Cardiac Research Institute was to launch a national community fundraising initiative which of the below would appeal to you most? Please select two.
An exercise initiative
A clean eating/healthy nutrition program
A weight loss challenge
A quit smoking support program
A meditation practice initiative
Which of the following would you like to hear more about? Please select those that appeal to you.
The late Dr Victor Chang
Real-life patient stories
Scientific breakthroughs
Heart disease & stroke
How to reduce your risk of cardiovascular disease
Would you consider donating to the Victor Chang Cardiac Research Institute in the future?
Please select
Yes
No
Additional Comments