Northwest Renal Network – Fax Back Request for:

 

Fistula First Educational CD/DVD Set

 

 “Creating AV Fistulae in All Eligible Hemodialysis Patients”

 

 

Fax to: 206-923-0716

 

Att: Lynda Ball, RN, BSN, CNN, QI Coordinator

 

 

 

From:  __________________________________________           Date:______________

            (Nephrologist originating request)

 

Contact phone #:_________________________________

 

 

Please send this CD/DVD training packet to:

(Provide surgical practice name, address and/or telephone number)

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____ We would like to explore other resources from the Network. Please contact us at:

 

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Or, contact Lynda at: 206-923-0714 extension 111   lball@nw16.esrd.net

Page updated 9/1/05