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Request an Appointment at Kidney Service

Kidney Service China is an in-network intermediary service provider and works with hundreds of leading kidney disease doctors and hospitals in China. Kidney Service China provides for kidney disease patients all over the world who would like to seek a treatment in China.

Request an appointment using our secure online form below. An appointment representative will contact you within two business days to review your medical information.

Patient Information

First Name:
Last Name:
Age:
Gender:
Country:
Phone:
Email:
Requester Information
Who are you requesting this appointment for?:
Medical Concern
Please list symptoms,diagnosis if you've received one, and reason for your appointment request:
Date Problem Started:
Name(s) and Date(s) of any recent tests:
What kidney disease does the patient have:
If you would like to provide additional information to the appointment staff, please add it here: