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Dialysis Patient Signup Form



(*) are required info(s)
Please enter your email.
Please enter your name.
Please enter your mobile number.
Please enter your address.
Please enter your address.
Please enter your city.
Please enter your postcode.
Please select your country.
Please select your state.
Please select your nationality.
Please enter your IC / Passport No.
Please enter your previous dialysis center name that you visit for dialysis treatment.
Please enter your previous dialysis center contact number that you visit for dialysis treatment.
; Please enter your previous dialysis center address that you visit for dialysis treatment.
Please enter your new account password.
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About us

The constraints imposed by dialysis treatments restrict a patient's mobility, as strict adherence to the treatment cycle is imperative. Any deviation from this prescribed cycle may have detrimental effects on the patient's overall health condition.


Our service is designed to assist dialysis patients in undertaking long-distance travel without the burden of concerns related to their treatment.



Connect with us
  • Contact us
  • Block D Tingkat 2 Unit 7, Plaza Hartamas,
  •       Jalan Sri Hartamas 1,Taman Sri Hartamas 
  •       50480 Kuala Lumpur, Wilayah Persekutuan
          Kuala Lumpur 
  • nhcdialysissupport@gmail.com
  • Nelson +60 12-8554811
    Mr Khoh +60 19-320 5512

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