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Make Your Will Do More
Please provide the following information to view the guide.
First Name
*
Last Name
*
Email
*
Zip Code
*
Connection to kidney disease
*
- Select -
I am a kidney patient
I am a family/friend of a kidney patient
I am a healthcare professional
I am a living donor
Other
Type of Kidney Connection
- None -
I am at risk for kidney disease
I have CKD Stage 1 or 2
I have CKD Stage 3
I have CKD Stage 4 or 5 and not on dialysis
I am on dialysis
I am a transplant recipient
A family member/friend is at risk for kidney disease
A family member/friend has CKD 1 or 2
A family member/friend has CKD 3
A family member/friend has CKD 4 or 5 and is not on dialysis
A family member/friend is on dialysis
A family member/friend is a transplant recipient
A family member/friend is a living donor
A family member/friend is a deceased donor
A family member/friend is a deceased patient
I have kidney cancer
I have kidney stones
A family member/friend has kidney cancer
A family member/friend has kidney stones
Dialysis Type
- None -
Patient - Home Hemo
Patient - Hemodialysis
Patient - Peritoneal
Patient - Dialysis Type Unknown
Patient - Nocturnal Hemodialysis
Professional Category
- None -
Nurse Technican
Resident
Social Worker
Dietitian
Physician Assistant
Fellows
Physician
Scientist
Pharmacist
Nurse Practitioner
Technician
Nurse
Other
Student
Clinical Nurse Specialist
Community Health Worker
Living Donation Type
- None -
Directed
Non-directed
Birth Date
*
Year
Year
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
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1944
1945
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1948
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1952
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1955
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1957
1958
1959
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1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Have you included NKF in your estate plans?
*
Yes
No
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