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Yuma Kidney and Dialysis Specialist
  • Services
    • Chronic Kidney Disease
    • Acute Kidney Failure
    • Hypertension Treatment
    • Hemodialysis and Peritoneal Treatment
    • Management of Anemia due to Chronic Kidney Disease
    • Fluid & Electrolyte Disorder
    • Post Kidney Transplant Care
    • Urinary Tract Infections
    • Kidney Stones Management
    • Urinary Bladder Incontinence
  • About Us
  • Our Providers
  • Locations
  • Contact
  • Accepted Insurances
  • Patient Resources
    • Patient Forms
    • Patient Portal
    • GFR Calculator
  • Educational Videos
  • Physician Referral
  • Careers
  • Blog
  • Employees
  • Logout
  • English English
  • Español Español

Patient Forms

If you wish to become a patient with Yuma Kidney & Dialysis Specialists.
Please download one of the forms below to print out and fill out, this will help speed up your appointment process.
Please DO NOT FORGET to bring the filled out form packet with you to your appointment.

New Patient Form (English)
New Patient Form (Spanish)
Physician Referral Letter

Office Hours

Monday - Friday : 8AM - 5PM

Contact Info

Email: info@yumakidney.com
Phone: (928) 388-6138

Multiple Locations

Ave A Location
2503 S. Avenue A, Ste 2
Yuma, AZ 85364
Phone: 928-388-6138
Frontage Rd Location
11468 N. Frontage Rd, Ste. A
Yuma, AZ 85367
Phone: 928-388-6138
San Luis Location
1453 N. Main Street, Ste. 3
San Luis, AZ 85349
Phone: 928-388-6138

Patient Resources

Patient Portal
New Patient Form (English)
New Patient Form (Spanish)
Physician Referral Letter
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