Sept-Oct 2022 series enrollment form
Please submit one form for EACH person that will be viewing any class in this series.  You may view the recordings at your leisure.  We strongly suggest viewing classes in order for ease of understanding, if possible.  Weekly live Q/A Zoom sessions (optional) will be held during the scheduled series.  
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Email *
Last name *
First name *
Health Insurer(s) - check all that apply.                       Some health insurers may ask Aloha Kidney for names of their members who have enrolled *
Required
What is your Zip code *
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