NW4 2018 Dialysis Event Training

Facility Information

CCN:
--Select CCN--
 
Reporting Month:
--Select Month--

Contact Information

Facility Contact First Name:
 
Facility Contact Last Name:
Facility Contact Email:

Dialysis Event Reporting

Dialysis Event Training was completed for this facility on:
RadDatePicker
RadDatePicker
Open the calendar popup.
I have a printed copy of the certificate of completion:
Note: Network 4 will randomly select a few facilities each month to submit the certificate of completion