Please use the following form to contact us with any questions, ideas, volunteer requests or feedback that you have.  We will review your message and get back to you as quickly as possible

If you are or know someone that would like to register with us, please download the following forms (PDF format):

Patient Request Form | Patient Registration Form

If you would like to make a donation, please click here or send your donation to the following address

HEARTS FOR ALS NY

P.O Box 10593

ROCHESTER, NY 14610