Exhibit 4.1


 


	NUMBER	SAILSM securities


U-


 


SEE REVERSE FOR CERTAIN DEFINITIONS


 


CUSIP 76155Y108


 


REVOLUTION HEALTHCARE ACQUISITION CORP.


 


SAILSM
(STAKEHOLDER ALIGNED INITIAL LISTING) SECURITY CONSISTING OF ONE SHARE OF CLASS A COMMON STOCK AND ONE-FIFTH OF ONE WARRANT
TO PURCHASE ONE SHARE OF CLASS A COMMON STOCK


 


THIS
CERTIFIES THAT ____________________ is the owner of ___________ SAILSM securities.


 


Each
SAILSM security (“SAILSM
security”) consists of one (1) share of Class A common stock, par value $0.0001 per share
(“Common Stock”), of Revolution Healthcare Acquisition Corp., a Delaware corporation (the “Company”),
and one-fifth (1/4) of one warrant (a “Warrant”). Each whole Warrant entitles the holder to purchase
one (1) share (subject to adjustment) of Common Stock for $[·] per share
(subject to adjustment). Each Warrant will become exercisable on the later of (i) thirty (30) days after the Company’s
completion of a merger, share exchange, asset acquisition, share purchase, reorganization
or other similar business combination with one or more businesses (each, a “Business Combination”),
or (ii) twelve (12) months from the closing of the Company’s initial public offering, and will expire unless exercised
before 5:00 p.m., New York City Time, on the date that is five (5) years after the date on which the Company completes its
initial Business Combination, or earlier upon redemption or liquidation (the “Expiration Date”). The
Common Stock and Warrants comprising the SAILSM securities represented by this
certificate are not transferable separately prior to , unless Morgan Stanley & Co. LLC elects to allow separate trading
earlier, subject to the Company’s filing of a Current Report on Form 8-K with the Securities and Exchange Commission
containing an audited balance sheet reflecting the Company’s receipt of the gross proceeds of the Company’s initial
public offering and issuing a press release announcing when separate trading will begin. No fractional warrants will be issued
upon separation of the SAILSM securities. The terms of the Warrants are governed
by a Warrant Agreement, dated as of , 2021, between the Company and Continental Stock Transfer & Trust Company, as Warrant
Agent, and are subject to the terms and provisions contained therein, all of which terms and provisions the holder of this certificate
consents to by acceptance hereof. Copies of the Warrant Agreement are on file at the office of the Warrant Agent at 1 State Street,
30th Floor, New York, New York 10004, and are available to any Warrant holder on written request and without cost.


 


This certificate is not valid unless countersigned
by the Transfer Agent and Registrar of the Company.


 


This certificate shall be governed by and
construed in accordance with the internal laws of the State of New York.


 


Witness the facsimile signature of its duly
authorized officers.


 


 


	Secretary	 	Chief Financial Officer


 












    


     


    

 


Revolution Healthcare Acquisition Corp.


 


The
Company will furnish without charge to each holder of a SAILSM security
who so requests, a statement of the powers, designations, preferences and relative, participating, optional or other special rights
of each class of stock or series thereof of the Company and the qualifications, limitations, or restrictions of such preferences
and/or rights.


 


The following abbreviations, when used
in the inscription on the face of this certificate, shall be construed as though they were written out in full according to applicable
laws or regulations:


 


	TEN COM	—	as tenants in common	UNIF
    GIFT MIN ACT	—	 	Custodian	 
	 	 	 	 	 	 	 	 
	TEN ENT	—	as tenants by the entireties	 	 	(Cust)	 	(Minor)
	 	 	 	 	 	 	 	 
	JT TEN	—	as joint tenants with right of survivorship and not as tenants in common	 	 	under Uniform Gifts to Minors Act
	 	 	 	 	 	 
	 	 	 	 	 	(State)


 


Additional abbreviations may also be used
though not in the above list.


 






    


     


    

 


For value received, ________________ hereby sells, assigns
and transfers unto


 


 


(PLEASE INSERT
SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER(S) OF ASSIGNEE(S))


 


 


(PLEASE PRINT
OR TYPEWRITE NAME(S) AND ADDRESS(ES), INCLUDING ZIP CODE, OF ASSIGNEE(S))


 


 


SAILSM
securities represented by the within Certificate, and does hereby irrevocably constitute and appoint


 


 


Attorney
to transfer the said SAILSM securities on the books of the within named Corporation with full power of substitution
in the premises.


 


Dated: ____________  




 


	 	 
	 	Shareholder  
	 	 
	 	Notice: The signature to this assignment must correspond with the name as written upon the face of the certificate in every particular, without alteration or enlargement or any change whatever.



 


Signature(s) Guaranteed:







 


	 	 
	 	 



 


THE SIGNATURE(S) MUST BE GUARANTEED
BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN
APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM, PURSUANT TO S.E.C. RULE 17Ad-15 (OR ANY SUCCESSOR RULE).


 


In each case, as more fully described in
the Company’s final prospectus dated , 2021, the holder(s) of this certificate shall be entitled to receive a pro-rata
portion of certain funds held in the trust account established in connection with its initial public offering only in the event
that (i) the Company redeems the shares of Common Stock sold in its initial public offering and liquidates because it does
not consummate an initial Business Combination within the period of time set forth in the Company’s amended and restated
certificate of incorporation, as the same may be amended from time to time, (ii) the Company redeems the shares of Common
Stock sold in its initial public offering in connection with a stockholder vote to amend the Company’s amended and restated
certificate of incorporation to modify the substance or timing of the Company’s obligation to redeem 100% of the Common Stock
if it does not consummate an initial Business Combination within the period of time set forth in the Company’s amended and
restated certificate of incorporation, as the same may be amended from time to time, or with respect to any other provisions relating
to the rights of holders of Common Stock, or (iii) if the holder(s) seek(s) to redeem for cash his, her or its respective
shares of Common Stock in connection with a tender offer (or proxy solicitation, solely in the event the Company seeks stockholder
approval of the proposed initial Business Combination) setting forth the details of a proposed initial Business Combination. In
no other circumstances shall the holder(s) have any right or interest of any kind in or to the trust account.