Copy of Intake Form Options

Affordable cardiac care for just a little over $1 a day

Join the SmartHeart Club

SmartHeart customers receive unique access to specialized 24/7 cardiology care, ongoing heart care education and unprecedented peace of mind.

Only $29/month with promo code Heart10

Continue

First-class cardiac care at home is here

Join SmartHeart today and experience high quality healthcare with your own-board certified cardilogist and around the clock access to medical guidance.

Included in your membership:

FDA cleared, hospital grade, 12-lead ECG device

Checks for signs of a heart attack, arrhythmias and other life-threatening heart conditions

For use with pacemakers and ICDs

Every ECG receives a clinical-quality report from a board-certified cardiologist

On demand virtual office visits with a US cardiologist - $65

Ongoing heart care and education from leading cardiologists

Month-to-month membership - cancel anytime

Satisfaction guaranteed or your money back

1 Background

2 Contact Info

3 Confirmation

4 Checkout

The First Step to Better
Heart Health

SmartHeart^© is a prescription-based 12 lead ECG device. We would like to learn a bit more about your personal medical history to better server your specific needs.

Please select any of the following conditions that apply to you:

I have had a heart attack before. I have a family history of sudden cardiac death. I have an implantable Pacemaker/Defibrillator. I have been diagnosed with cardiomyopathy or congestive heart failure. I have a history of atrial fibrillation. I want to be proactive about my health.

Your personal information is safe with us and protected according to our strict Privacy Policy.

★★★★★

When it comes to your heart

every minute counts. It’s scary to say that if I had waited just 10 minutes longer to use SmartHeart, I wouldn’t be here today.”

Let’s Gather Some Information

Please provide some details about yourself below.

Tell us about yourself

First Name

Last Name

Gender at Birth

Male Female

Provide your contact number and email address

(000) 000-0000

you@your-email.com

★★★★★

Everyone needs a smartheart at home.

While making dinner, I wasn’t feeling well so I performed an EKG. A cardiologist compared my results to a previous report and reassured me that it wasn’t an emergency, but I should see a doctor soon.”

Take Control of Your Heart Health

SmartHeart® members must be at least 18. We provide services in most states, but not quite all (yet).

Please enter your date of birth*

Member state of residence*

*By clicking ‘Submit’, you agree to the SmartHeart Terms of Use and Privacy Policy, and the Telehealth Consent Policy.

★★★★★

It’s been five years since my open-heart surgery.

One day, I suddenly felt like I was going to pass out. The SmartHeart team reviewed my EKG and assured me that everything was OK.”

Thank you for reaching out!

We have saved your email address and will notify you when Smartheart® becomes available in [state].

Back to Homepage


                

                

                

                For development: print form answers into console (this line will be removed later):
                Print

Fast, Free Shipping
Once prescribed, SmartHeart ships free, directly to your door. Activate your membership and start performing ECGs.
24/7 Rapid Results
Our expert team is available around the clock to review your ECG results.
Portable Device
This lightweight and compact 12-Lead ECG device can be taken anywhere and everywhere.
Personalized Healthcare
Review your ECG results one on one with a board-certified cardiologist.