Kidney Talk Tuesdays Registration

Thank you for your interest in our Kidney Talk Tuesdays series presented at 7pm. Our series for the kidney patient, caregivers, and families! Please complete the registration below and a ZOOM link and all applicable information will be sent to your email.

Question Title

* 1. Contact Information

Name

ZIP/Postal Code

Email Address

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* 2. Are you a...

Patient

Caregiver

Other (please specify)

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* 3. Have you or a loved one started dialysis?

Yes

Other (please specify)

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* 4. Have you or a loved one received a kidney transplant?

Yes

Other (please specify)

Kidney Talk Tuesdays Registration

Question Title

* 1. Contact Information

Question Title

* 2. Are you a...

Question Title

* 3. Have you or a loved one started dialysis?

Question Title

* 4. Have you or a loved one received a kidney transplant?

Question Title

* 5. How did you hear about the Kidney Talk Tuesday series?

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* 6. What topics would you be interested in being presented at Kidney Talk Tuesday?