If you wish to receive support from Revie’s Rule, please fill out this application to the best of your knowledge and someone will be in touch with you shortly.

If you are in immediate danger or need urgent medical assistance, please call 911 right away.

At Revie’s Rule, we are not a healthcare provider but a family-first advocacy organization dedicated to supporting medically complex children and their families. Your privacy matters deeply to us. All information you share will be kept confidential.

If your situation is urgent but not life-threatening, please let us know so we can prioritize your request. We are here to stand beside you.

By submitting this form, you confirm that you understand Revie’s Rule is an advocacy organization and not a medical provider. We cannot offer medical advice or treatment. Your information is confidential and used solely to connect you with the appropriate advocacy support. View privacy policy