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Dialysis Technician Course Interest Form

Thank you for your interest in the non-credit Dialysis Technician course. Please use the form below to submit your contact information. Our staff will contact you once registration is open for the next scheduled class.

Contact Information

First Name

Last Name

Phone Number

Email Address

Address

City

State

Zip Code

A valid ND Certified Nursing Assistant License is strongly recommended prior to taking the Dialysis Tech course. Please indicate your status below.

I have a current CNA license

My CNA license is expired

I am interested in CNA training also

I have not had a CNA license (does not necessarily bar you from the program)

To complete the Dialysis Tech course, you will need your seasonal flu vaccine & disclose your also need to be fully vaccinated for COVID-19 per the requirements of the training facility (not BSC). Please confirm below that you understand.

Yes

Completing this form does not lock you into course registration, but will provide a means of communication when more course details are in place.