How to register
To register, a patient needs to complete our forms and provide a documentation as it follows:
APPLICATION FORM including:
– personal data, address, phone number (e-mail)
– diagnosis, allergies, daily therapy.
– hemodialysis information: duration, type of dialyzer, anticoagulation therapy.
– blood test results: hgb, hct, levels of glucose, urea, kreatinine, K, Na.
– results of viral markers for HBV, HCV, HIV – no more than 30 days old.
– desired treatment period (1) and alternative treatment period (2) as well as the number of hemodialysis treatments.
Application formMedical dialisys protocol
To fill all necessary fields you must save pdf document to your computer and open it with Adobe Reader application. Filled form/document then you can send via e-mail or print it out.
Adobe Reader application you can download on following link:
– EHIC (European Health Insurance Card) – Official document for the hemodialysis treatment free of charge.
– PRIVATE, information regarding payment method.
- Only patients negative for markers are treated at the Center.
- We do not carry out HDF.
- The booking of the appointment will be confirmed after the following paperwork has been provided:
- Application form
- Medical Dialysis Protocol
- EHIC – (please send a copy)
- Private payment method
- Confirmation of patient’s arrival.