Online Kidney Support Community Registration
Complete the form below to join an upcoming, mentor-guided session via Zoom. You will receive an email with the session information including a link to the video meeting.
Name
*
First Name
Last Name
Are you currently enrolled with ReMend and meeting with a Mentor?
*
Please Select
Yes.
No.
Date of Birth
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone (text/voice)
-
Area Code
Phone Number
Where are you in your kidney journey?
*
Stage 3
Stage 4
Stage 5/ESRD
Preparing for dialysis
Transplant evaluation/waiting
Post-transplant
Caregiver/Family Member
Not sure
What topics would be most helpful right now?
Dialysis day-to-day
Food & fluid tips (peer experience)
Energy, sleep and coping
Work, family and life logistics
Transplant planning/waiting
Mental wellness & staying motivated
Other
Required checkbox acknowledgements:
“I agree to be respectful, protect privacy, and help keep this a supportive space.”
“I understand ReMend Mentors share lived experience and are not providing medical advice.”
“I agree that ReMend may contact me about my registration and session details.”
Submit
Should be Empty: