Information Request for the CKD Change Package and Population Health
First Name
Last Name
Email
Phone Number
Role/Title
Institution/Company Name
Company Type
Hospital or Health System
Clinic or Independent Practice
Department of Health (state or local)
Federally Qualified Health Center
Health Plan
Quality Improvement Organization
Other
Please describe "Other" choice for Institution/Company Type
Zip Code
Purpose of Inquiry (Please select all that apply)
I have a technical question about the CKD Change Package or would like help implementing the Change Package
I would like technical assistance from an NKF Population Health expert in facilitating one or more strategies within in the Change Package
I’d like to learn more about NKF’s CKDintercept initiative and other NKF resources to improve CKD testing, recognition, and management
Interest in CKD educational resources for clinicians
Interest in CKD educational resources for patients
Other (please describe)
If your information request is for a specific stage of the Change Package, please select that stage
Stage of Change 1: Understand CKD and its Management in Primary Care
Stage of Change 2: Assess the Quality of CKD Care in Your Institution
Stage of Change 3: Building the Business Case to Improve CKD Care
Stage of Change 4: Convene a Multi-disciplinary Team
Stage of Change 5: Develop the Implementation Plan for Your CKD Intervention
Stage of Change 6: Execute and Measure Your Impact
General Information Request