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Ite, complete one row on this log and complete one Dialysis Event form. Please refer to the Dialysis Event Protocol for reporting guidelines and procedures. Data from this log are not entered---this log is for your own use. Patient s Name Date (mm/dd) Dialysis Event Type Event Form Completed? 1. / Y 2. / Y 3. / Y 4. / Y 5. / Y 6. / Y 7. / Y 8. / Y 9. / Y 10. / Y 11. / Y 12. / Y 13. / Y 14. / Y 15. / Y 16. / Y 17. / Y 18. / Y 19. / Y.

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