NKF Support Request

NKF Peers is a free program that connects people 1-to-1, over the phone, with a trained peer mentor. Peer mentors are people who have experience with chronic kidney disease (CKD) or are living donors who have experiences that they can share with you. NKF Peers is for people who have CKD Stage 4/5, are on dialysis, have a transplant, are considering becoming a living donor or have already donated a kidney.


Please complete the following form to get you connected with a peer mentor who has experience with kidney disease or being a living donor. If for some reason you have difficulty completing the form or would like to speak to someone about more details on the NKF Peers program, please call 855-653-7337. We are available to answer the phone Monday – Friday, 9am-5pm EST.


Note: Mentors are not able to help you decide what medical professional or hospital to go to, what medication to take or what medical decision you should make. You should always refer to your healthcare team before making any changes to your treatment plan, medications, or diet.


You can view the National Kidney Foundation Privacy Policy HERE.


*This program is open to U.S. Residents only.


We are sorry, however, this program is only for U.S. Residents only.


CONTACT INFORMATION
The following questionnaire will take between 5-10 minutes to complete

















CONNECTION TO KIDNEY DISEASE













TRANSPLANT RECIPIENT







CONSIDERING LIVING DONATION


LIVING DONOR INFO




DEMOGRAPHIC INFO





ADDITIONAL INFORMATION







ORDER ITEM TOPICS

ORDER ITEMS














Below are some statements that people sometimes make when they talk about their health. Please indicate how much you agree or disagree with each statement as it applies to you personally. Your answers should be what is true for you and not just what you think others want you to say.
 Strongly Disagree Disagree Agree Strongly Agree N/A
Please fill out which days and times are best for your mentor to reach you. Your mentor will be reaching out to you and will only be able to do so during the days and times that you indicate below.