Request Dialysis Treatment
You are requesting treatment at:
DaVita Fayetteville Dialysis 1279 Highway 54 W, Ste 110Fayetteville, GA 30214-4551
Phone: 1-800-424-6589 Fax: (678) 817-9930
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.
Note: You only need to submit this form once per arrival date. If we can't find availability at this particular center on the date you requested, we will try to find the closest available center.
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."