Patient Admissions
Email us at Admissions.Inbox@USRenalCare.com.
Submit your admissions packet
Click the button below to download and complete your admissions form. To allow for an efficient admission process, please ensure the following documents are available before contacting the U.S. Renal Care Admissions Department.
Documents for patients new to dialysis
Required*
- Completed admissions form
- Demographic sheet, including insurance info
- History and Physical and/or last 2 Nephrologist notes (within last 30 days)
- Last 3 dialysis flowsheets
- HBsAg (within last 30 days)
Requested if available
- Labs (within last 30 days)
- HBV panel (within last year)
- PPD, Chest X-Ray, QuantiFERON-TB Gold (QFT) (within last 30 days)
- COVID Vaccination Record
*DE, HI, NY require complete HBV panel (within last year); TX, NJ require complete HBV panel (within 30 days); HI requires PPD or CXR; AZ, CO, DE, SC require H&P (within last 30 days)
Documents for patients transferring to a U.S. Renal Care center
Required
- Completed admissions form
- Demographic sheet, including insurance info
- History and Physical (within last 1 year)
- Last 3 dialysis flowsheets
- HBsAg (within last 30 days) or anti-HBs ≥10 (within last year)
- 2728 Form
Requested if available
- Labs (within last 30 days)
- HBV panel (within last year)
- External USRC: PPD, Chest X-Ray or QuantiFERON-TB Gold (QFT) (within last year)
- Internal USRC: TB verify in EMR
- Plan of Care (current)
- COVID Vaccination Record
Simple admissions process
We have an efficient process to manage every aspect of admissions and advocate for every patient.
1. Referral received
- Medical records are requested
- Patient is admitted into pre-registration system
2. Medical records received
- Clinical review completed
- Submitted to Insurance Team coverage check
3. Placement confirmed
- Referral source is notified
- Patient admitted to clinical EMR system