Informed Consent and Liability Waiver

1. Introduction of services

I, [Parent/ Guardian Name], as the parent or legal guardian of [child’s name], am voluntarily seeking support and advocacy services from Revie’s Rule. I understand that the Revie’s Rule is a non-profit entity that provides resources and layperson advocacy for parents of medically complex children. I acknowledge and agree that Revie’s Rule, including its staff and volunteers, does not provide medical advice, diagnosis, treatment, legal counsel, or financial advice.

2. No Medical or Legal Advice

I understand and agree that any information, guidance, or resources provided by the organization are for educational and informational purposes only. Revie’s Rule and its representatives are not licensed medical or legal professionals.

  • I am solely responsible for all medical decisions regarding my child’s care and treatment and will consult with licensed healthcare professionals for all medical advice. 

  • I will not disregard or delay seeking professional medical advice based on any information received from Revie’s Rule.

  • Revie’s Rule cannot and will not represent me in any legal capacity. If I require legal advice, I will hire a qualified attorney at my own expense.


3. Release of liability

In consideration for the services provided by Revie’s Rule, I hereby release, acquit, and forever discharge the organization, its employees, and volunteers from any and all liability claims, demand, damages, and causes of action. This release includes claims for bodily injury, personal injury, illness, death, or property damage, whether known or unknown, that arise out of or relate to my participation in this program. 

4. Assumption of risk

I am aware that participating in a medical advocacy program involves risks, including the possibility of differing opinions on medical care. I knowingly and voluntarily assume all risks associated with my participation and the services provided by Revie’s Rule.

5. Confidentiality and mandatory reporting

Revie’s Rule will make a reasonable effort to protect my family’s privacy. However, I understand that under the state’s law, Revie’s Rule’s representatives may be required to disclose confidential information to appropriate authorities in certain situations, including instances of child abuse, elder abuse, or abuse of diabeled individuals 

  • I consent to share information related to my child’s medical condition for advocacy purposes, with the understanding that Revie’s Rule will respect our privacy and use the information responsibly within the bounds of the law.

  • I understand that in the event a representative of Revie’s Rule suspects abuse or neglect, they are legally obligated to make a report to the proper authorities. 


6. Indemnification

I agree to indemnify and hold harmless Revie’s Rule, including its employee and volunteers, from any and all claims, expenses (including attorneys’ fee), or liability that may arise from my or my child’s participation in this program. 

7. Acknowledgment and understanding

I have been given a reasonable amount of time to review and consider this agreement. I  have read and fully understand its terms, and I consent freely give and voluntarily without coercion. I am not relying on any statements or assurances from Revie’s Rule that are not included in this document.