Go to the Ronald McDonald House Louisville website.
Online Registration
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Guardian/Caregiver Name (First and Last)
**A significant amount of daily participation and visitation with the patient is expected during your stay (4-6 hours per day). Not meeting this expectation will jeopordize stays at RMHCK.
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Primary Phone Number
I agree to receive texts at this number.
**Guest rooms must be used on a daily basis. Guests with repeated non-use of room within a 24-hour period may forfeit their continued stay with RMHCK.
**Notify Front Desk if you experience symptoms that could potentially be a contagious disease
RMHCK can text me with important information
Please select a response
No
Yes
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Check In Date
*
Date of appointment (understanding that Doctors appointments are a one day stay unless otherwise noted on referral)
Help Request Sent
Ok
Name of person completing this form
Patient Name ( First and Last )
Phone
Email
Submit
