Generators : Fresenius Bibag equiped by Diasef module

Filter  : Different types of biocompatibles membranes.

Treatment of water : Biosomose.

Dialysat : Acetate and Bicarbonate.

Air-Conditioned rooms

Transport : By the clinical ambulance.

Qualified personnel.

Medical permanent assistance.

Reservation sheet

Surname   

Name        

Adress     

Zip code   

City       

Country       

Phone      

Fax   

E-mail   

 Social security  

Caisse    

Matricule   

 Dialysis parametres

Date  :  From                                             To    

Dialysis Days    1        2           3    

 

Number of sessions   

Number of hours    H

Sessions    

Dialysis  method             

Filtre :  Type of  membrane        Surface :   mē

Serology

HBS +         

HIV  +         

HCV +          

Name and adress of your usual treatment center :