LV Registration & Payment

 

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First Name:
Last Name:
Spouse Attending (Optional):
Email:
Address:
Zip:

Please indicate how many will be attending each activity for planning purposes only, and make menu selection were applicable.

Friday, October 7 Meet and Greet:
Saturday, October 8, 2016 Educational Session:
(coffee break)

Saturday, October 8, 2016 Awards Luncheon

Choose from the following for each attendee:
Chicken:
Salmon:
Pasta:

Sunday, October 9, 2016 Roundtable Brunch:

Early Bird Registration (until September 1, 2016)

$50 per person:
$75 per couple:
TOTAL Submitted:


Dialysis Information

DaVita, Inc.; Dialysis Clinic, Inc.; and Fresenius Medical care Patient Travel Services can provide dialysis treatments for those needing this service during convention. Attendees are solely responsible for scheduling their treatment(s), and we encourage you to do so well in advance, working with your center’s travel coordinator.

DaVita: Customer Care Representative 855-744-6852
FMCNA: Patient Travel Services, 866-434-2597

SHIPPING MEDICAL SUPPLIES

Peritoneal Dialysis and Home hemodialysis supplies can be shipped directly to the hotel. Label boxes with guest name and “HDU Patient Meeting Attendee Medical Supplies.” and your name. Circus Circus is waiving all hotel fees for attendee medical supply boxes. To ensure you will not be charged, please label boxes appropriately. HDU is not responsible for any charges for mislabeled boxes.

In order to insure that your supplies are properly received and delivered please include the number of boxes you expect to receive with your reservation here

Patient Name
Number of Boxes

Reservation Name
Confirmation

PLEASE NOTE: Your Registration Fee is 100% tax deductible, and is made as a Donation to Home Dialyzors United, to help defray some of the conference costs.

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