Join DPC

Thank you for your interest in joining Dialysis Patient Citizen’s network. To get started, fill out the fields below so that we can better assist you.

Salutation*

Is the primary phone entered a cell phone?*

Membership Type*
Please select your membership option. Choose General Membership if you are a patient or family member, Partners in Care if you are a healthcare professional or Friend if you are unaffiliated with kidney disease but interested in joining our community.

Dialysis Status*
Please indicate your relationship to dialysis.

Relationship to Dialysis*
Please indicate your relationship to dialysis.