Dialysis Access Center


DAC Survey

  1. Please provide the following contact information:

                Name 
               Title 
        Organization 
      Street Address 
     Address (cont.) 
                City 
      State/Province 
     Zip/Postal Code 
             Country 
          Work Phone 
                 FAX 
              E-mail 
                 URL 
    
  2. Choose one of the following options:


  3. How many Nephrologists are there in your practice?


  4. How many chronic dialysis patients your practice cares for?


  5. What do you think of Dialysis Access Care by Nephrologists?



Webmaster: Oliver Khakmahd, MD
Copyright 2000 [DACC]. All rights reserved.
Revised: May 26, 2004