Support Intake Form

By submitting this secure online form, I agree that the information I provide for myself or my child may be used by the AVM Alliance and their Support Specialists solely for my participation in the AVM Alliance Support Network. I understand the Support Specialist is a volunteer for AVM Alliance, and their opinions and comments reflect their personal experience in the diagnosis, testing, and treatments only and are not that of AVM Alliance or medical professionals. I certify that I am 18 years or older. I may revoke this consent by contacting AVM Alliance at
Relationship to Child/Adolescent(Required)
We are here to support you in the best possible way. To ensure we address your needs effectively, please fill out the additional comments section below. Share relevant details about yourself, your child, or any specific questions you may have. A dedicated Support Specialist will reach out to you via email within 2 business days. Please note that we are not medical professionals, so we cannot review any diagnostic tests or provide medical advice. Unfortunately, we are unable to provide direct financial support.
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