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+ 1 541-754-3010

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+ 1 541-754-3010

Online Forms

Here are some important forms you to review and complete prior to your appointment with one of our physicians or provider.

  • Screening Checklist for Visitors
  • New Patient Enrollment Form
  • Medical History Form
  • Online Doctor Appointment Form
  • Psychiatric Evaluation Form
  • Quick Emergency Contact Form
  • Blood Donation Form
  • HIPAA Privacy Restriction Questionnaire
  • Medical Release Form

Merging over a decade of specialized operational expertise to strategically develop private haemodialysis centres, nationwide.

 

+60 3-2202 0565

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Contact >

Address

T2A-12-05, 3 Towers, Jalan Ampang

Operating Hours

For Treatment:
Mon - Sat: 6:30 am - 8:30 pm
Admin:
Mon - Fri: 10:00 am - 4:00 pm

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+ 1 541-754-3010

Use only for Stomach pain, Trauma,
Headache, Bike accidents etc…

 

For more serious problems 
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Boston, USA 55 Huntington Ave Ste

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