If you need dialysis treatments within the next 7 days, call 1-800-244-0680 and a Guest Services Contact Center Teammate will assist you. Otherwise, if you have more than 7 days to plan, complete this form in its entirety. Please have your destination address and or zip code available before you begin. This information is required in order to find the closest available facility to your destination.
Important note for Peritoneal Dialysis patients: If you're wishing to travel and would like a back-up facility call 1-800-244-0680.
All fields are required unless marked "optional."
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