Forms
There are no fees for our help.
We are not affiliated with the RENAL industry, we are a pending non-profit dedicated to helping Dialysis patients and their family who are having problems with their care.
If you need assistance you can download these forms.
Click on each form; once it opens right click on it select Save As and save to your desk top. You can then print and fill it out. Once filled out you can fax it to 888-213-5733 or scan and email to:
arlene-mullin@dialysisadvocates.com
Form for assistance: advocasy-form
Guide: guide-for-filling-forms
Example: example-filled-form.
Due to HIPPA laws we cannot assist you until the form has been filled and signed.
