Introduction: The American Heart Association (AHA) Mission: Lifeline Stroke program is a 3-year statewide initiative in North Dakota which aims to improve consistency of guideline-based care of stroke patients thereby improving outcomes. In year one a public awareness assessment of stroke awareness was completed. Purpose: The intent of this survey was to establish a baseline of symptom awareness related to the F.A.S.T acronym, actions and behaviors when stroke is suspected, and media preferences in ND. Methods: The AHA commissioned Marketing & Advertising Business Unlimited, Inc., to conduct a telephone survey. Four hundred phone interviews were completed with ND residents by random selection from a list of 24,000 residential landlines and 8,000 mobile phones. Numbers were stratified into five distinct regions to ensure a proper urban/rural balance. Data was also weighted by gender, age, and region to conform to the latest statewide census projects. The telephone survey had a 4.9% margin of error and a 95% confidence interval. Results: Forty seven percent of respondents stated that they had learned the signs of stroke, however only 17% classified themselves as very familiar. The most common signs identified were “Speech/Slurred Words” and “Face/Drooping Face” at 39% and 30%, respectively. In terms of F.A.S.T. awareness, 46% of survey respondents correctly identified “Face” while only 15% identified “Time.” “Arm” and “Speech” were identified 32% and 23%, respectively. Respondents indicated they would call 9-1-1 64% of the time. When asked why it may be better to be transported by personal vehicle, 74% responded you may be able to get to the hospital faster. Men and those over 65 were far less likely to correctly identify the components of F.A.S.T. Media preferences expressed were: 1) F.A.S.T. acronym over other longer options, 2) visual examples with real humans versus icons, 3) the tagline “Care Starts When You Call”, and 4) television and Facebook were the preferred mediums. Conclusions: Overall, the survey data is encouraging and may provide guidance for future rural programs. A significant portion of the respondents were deficient in stroke symptom awareness, however most survey respondents expressed interested in learning these symptoms.