Language
English (US)
Spanish (Latin America)
Kidney Conversations
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 matched with ReMend Mentor?
*
Please Select
Yes.
No.
Not sure.
Email
*
example@example.com
Phone (text/voice)
-
Area Code
Phone Number
For which session are you registering? (all pacific time)
*
Thursday, May 14 at 5pm hosted by Jim
Monday, June 1 at 10 am hosted by Jeanmarie
Is there anything you’d like the Mentor to know ahead of time?
Age Range
*
18-24
25-34
35-44
45-54
55-64
65+
Where are you in your kidney journey?
*
Stage 3-4
Stage 5/preparing for dialysis
On dialysis now
Considering transplant/on waitlist
Post-transplant
Caregiver/Family Member
Prefer not to say
How did you hear about this session?
*
ReMend Mentor
Dialysis Clinic
Doctor, Clinic Staff
Friend/Family
Social Media
Email/Newsletter
Other
What topics would be most helpful right now? (choose any)
Understanding labs and what they mean
Food and nutrition basics
Dialysis: getting started / choosing a type
Transplant: evaluation, waitlist, living donation
Talking with doctors and feeling heard
Managing stress, fear, or burnout
Energy, fatigue, and daily life
Work, insurance, or practical resources
Supporting a loved one (for care partners)
Other
Required checkbox acknowledgements:
*
I will be respectful and help keep this a supportive space.
I will protect privacy (mine and others’) and not share what I hear outside the session.
I understand this session offers peer support and education—not medical advice.
I agree that ReMend may contact me about my registration and session details.
Submit
Should be Empty: