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Title of material submitted:*
Author(s):*
Submissions will be evaluated using the following criteria:
Does the submission have a positive message regarding AV fistulae?
Yes
No
Which Change Concept will this submission be assigned to?*
Identify on what this submission is based:
KDOQI CPG
Evidence-Based Research/Practice
FFBI
Conditions for Coverage
None
Other, please specify:
Who is the target audience?
Nephrologist
Surgeon
Primary Care
Interventionalist
Nephrology Nurse/Technician
CKD
For paper submissions, has it been published within the last 5 years?
Yes
No
Is there any reason why the paper should be included if published beyond 5 years?
Historical
Only papers on the subject
Information still pertinent
For forms submissions, is it current within the last 2 years?
Yes
No
(If longer than 2 years, the information must be current with KDOQI, FFBI, and CfC.)
Does the submission have references?
Yes
No
The submission is created in:
Word
Excel
Power Point
Other, please specify:
Does the submission need a template/PDF?
Yes
No
Upload your resource:
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1000KB Maximum
File Types:
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