Do you or the person you are caring for ever experience?

Have you or the person you are caring for ever experienced the following symptoms?

Are you or the person you are caring for on blood thinners?

Are you or the person you are caring for considered at high risk of bleeding?

Have you or the person you are caring for ever been diagnosed with atrial fibrillation (AFib)?

When was the last time your doctor performed one of the following?

Listened to your heart

Measured your blood pressure and heart rate

Weighed you

Asked about your physical activity level

Do you or the person you are caring for have a family history of heart disease?

Please provide the information below for you or the person you are caring for

Month of birth

Year of birth

My gender assigned at birth is

Thank you for completing our heart health quiz

You should consult your doctor or specialist to determine what treatments are right for you. Use our Find a Specialist to explore specialists in your area.

Complete and submit the form below to get access to a guide to discuss with your doctor or specialist.

The discussion guide is intended to support you in preparing for a discussion with your doctor, including to assist you in discussing your symptoms, and which AFib treatment options could be right for you.

You can download the guide with your answers and print for use before, during, and after your next appointment. The discussion guide is not a diagnostic tool and does not offer medical advice.

First Name*

Last Name*

Email*

Phone (include area code and/ or country code)

State*

Post code

*Mandatory fields

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