AmbitCare Registration

Fill out and sumbit this form to register for AmbitCare

AmbitCare Registration

AmbitCare provides you and your child with the following services free of charge:

  • Access to free AmbitCare Ambassadors who can provide 1:1 support tailored to you and your child’s needs
  • Information provided by AmbitCare about:
    • Navigating the healthcare system
    • Genetic counseling and genetic testing
    • Potential underlying causes of seizures and developmental delays and relevant terms
    • Clinical trials for rare childhood seizure disorders
    • FDA-approved medications for your child’s condition (if available)
    • Relevant organizations and resources
    • Connections to specialized healthcare providers
  • Helpful resources for caregivers with medically complex children
    • Tools to help you keep track of your child’s medical information
    • How to advocate for your child
  • Access to free virtual genetic counseling for qualifying patients.
    Tools to help you keep track of your child’s medical information
  • How to advocate for your child

Any information you submit may be stored, reviewed, and analyzed by AmbitCare for purposes of connecting you with relevant resources. AmbitCare does not sell your personal identifiable information to others. Only your de-identified, summary data is shared with our research partners, such as academic researchers, advocacy groups, and pharmaceutical companies, if you consent in an effort to advance treatment options. For more information on AmbitCare’s Privacy Policy and Terms and Conditions go to www.ambitcare.com/privacy.