top of page

ADMISSION SHEET

Once the availability of your reservation has been confirmed, for your final confirmation we need you to complete this admission form, which you must send us, as well as the requested documentation, via fax or email three weeks before the date of the first dialysis.

  IMPORTANT NOTICES

PREVIOUSLY COMPLETE THE "RESERVATIONS" FORM

We can only admit patients free of Hepatitis B, C and COVID and its variants.

 

A Medical Report and Dialysis Protocol will be provided, carried out by the usual treatment center.

Serology must be provided  of Hepatitis B and C, HIV, carried out thirty days maximum before the date of the first dialysis.  

COVID PCR test will be provided  performed 72 hours before the first dialysis and Certificate  of COVID Vaccination.

.

You must bring the medication that you usually need.However, you can purchase the EPO you need for your holiday treatment at our centre.

Letter of acceptance of payment from the Insurance Company in favor of Club Diálisis Vacacional SL

Being our private centers, we do not accept the European Health Card, E-111 as a means of payment.

When you manage the letter of acceptance of payment of the  Insurance Company, check carefully that it does not require you to pay the cost of dialysis beforehand in our centers and claim the expense later from the Company, in which case, if you are not satisfied, you should contact your insurance company before travelling.

Please note that as a general rule, our medical services need to have  the required medical information at least three weeks before the first holiday dialysis.

The marked fields are required.

CLUB DIALISIS VACACIONAL
VACATION PATIENT FORM

We recommend that you print this page before clicking Send

! Thanks for your message. We will reply to you shortly!

bottom of page