Pre-Travel Medical Form

March 14, 2026
1 min read
Pre-Travel Medical Form

About This Form

Complete this form with your nephrologist or dialysis team before your trip. Carry a printed copy at all times — it allows any international healthcare provider to understand your medical situation quickly.

What It Includes

  • Full medical history summary
  • Dialysis treatment details (modality, frequency, duration)
  • Prescribed medications and dosages
  • Allergies and contraindications
  • Doctor and dialysis center contact information

📎 Download the PDF below and fill it in with your healthcare team before departure.

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Travel with Confidence

Dialysis should not stop you from living your life. When you download the Renal Traveller app on your mobile — download on iOS or Android — you carry a digital solution in your pocket, making holiday dialysis booking simple and fast. All clinics on our website are trusted and verified partners, so you can travel with peace of mind.

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