Submit a Health Literacy Hero Here

Below please fill out all required fields and we look forward to reviewing your submission. Together we grow our knowledge, our influence, and our mission.

— Thank you for your submission.

Health Literacy Hero Directory Submission Form

Hero Name*

This can be either the name of the individual, name of the team, or organization as per "Type of hero" selected.
Type of hero*
Please select either Individual, Team, or Organization.
Date
Date Format: MM slash DD slash YYYY
Hero Affiliation*
This may include job title, employer, or community affiliation.
Hero Description*
Please indicate "Why ____ is a health literacy hero. Describe in 100-200 words.
Contact Name*
First Last
This is the name of the individual submitting the hero.
Upload a photo
This is to display either a photo of the individual, team, or organization. Graphic can also be a logo of the organization as an alternative. For best results, please upload an image of at least 1200px wide x 628px high.
Contact Email

This is the email address of the person submitting the hero.
CAPTCHA
Terms and Conditions*
I agree to the terms and conditions below.
I give permission for "healthliteracymonth.org" to accept, edit and post this listing.