Dialysis Patient Information Consent Form

Form Template

It is always a patient's choice to share information and data about their own health status.

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When traveling, and far removed from their own dialysis treatment center, patients may find comfort in the transfer of data regarding treatment and specifics related to patient care. The Dialysis Patient Information Consent Form can be used for sharing personal data for the purpose of transmission and coordination of dialysis treatments. In the case of an emergency while traveling or on vacation, should a patient with kidney disease require medical services or need to go to the hospital, this form would be critical for the patient to have details of dialysis services communicated from their home facility to emergency medical technicians. The Dialysis Patient Information Consent Form app is an essential tool to add to a treatment plan for comprehensive patient care.

Use this app to best facilitate medical decision-making by health care providers at a dialysis facility when a patient is traveling. Promote patient safety during the decision-making process that leads to choosing the most effective treatment. As clinicians and health professionals on a dialysis unit, use this app to make health care decisions on treatment options that lead to the best quality of life for patients who are making care transitions for renal disease.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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