Dialysis Clinic, Inc.

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Camp Okawehna - Forms

The Camp Okawehna registration applications and other necessary forms are listed below. Refer to the appropriate checklist (Hemodialysis, PD, Transplant or Other, Counselor, Child of Counselor) for the forms you must complete to attend Camp.

The forms below are fill-in forms, which means you can enter information on the screen while it is displayed in Adobe® Acrobat® Reader™ and then print the completed form. You also can print the blank form and fill it in using a pen. Instructions for both methods are provided at the bottom of this page.

You also can read the History and Mission Statement for Camp Okawehna and see a list of What to Bring to Camp.

If you do not have Adobe Acrobat Reader installed on your computer, you can download it for FREE.

WARNING: Some versions of Adobe Acrobat Reader do not allow you to save your fill-in form.

Hemodialysis Patients

Hemodialysis Camper Packet (PDF - click to fill/print out)
Copy of insurance cards
Copy of most recent Hepatitis Lab Results
Copy of most recent doctor visit with vital signs and list of medications

PD Patients

PD Camper Packet (PDF - click to fill/print out)
Copy of insurance cards
Copy of most recent doctor visit with vital signs and list of medications

Transplant or Other Patients

Transplant Camper Packet (PDF - click to fill/print out)
Copy of insurance cards
Copy of most recent doctor visit with vital signs and list of medications

Counselors

Counselor Packet (PDF - click to fill/print out)
If performing Hemodialysis or Peritoneal Dialysis on campers, submit a copy of your nursing license and CPR certifications. If you are a physician, submit a copy of your medical license.

Children of Counselors

Children of Counselors Packet (PDF - click to fill/print out)
Copy of insurance cards
 

 

 

 

Filling Out the Forms Online

  1. Referring to the checklists above, find the type of camper/counselor you are.
  2. All online forms and other necessary information are listed.

  3. Any forms with the "PDF" indication mean it is an online form. Click on the first online form name.
  4. The form opens in Abobe Acrobat Reader.

  5. Click the mouse cursor in the first data entry field.
  6. A flashing cursor appears in the first data entry field.

  7. Type the requested information in the data entry field.
  8. Press the TAB key on your keyboard to move your cursor to the next data entry field.
  9. NOTE
    To insert the checkmark character into checkbox fields, click the checkbox with your mouse.

  10. When you finish typing the requested information, scroll to the top of the form.
  11. To print the form to your default printer, click the Print Form button located in the upper right-hand corner of the form.
  12. (Microsoft® Internet Explorer Users) Click the Back button in the browser toolbar to close the form and return to the checklist.
    (Netscape® Users) Select File»Close from the menu bar to close the form.
  13. WARNING
    The information that you typed will not be saved.

  14. If the form has a signature field, sign the printed form in pen.
  15. Referring to the checklist, provide copies any other necessary information (ex., copy of insurance cards, doctor's notes, medical licenses, etc.).
  16. Fax all requested information to the Camp O Processing Department, Attn: Glenda Streicher at (615) 341-8814.

OR

Mail all requested information to:
Camp Okawehna Processing Department
Attn: Glenda Streicher
1633 Church St, Suite 500
Nashville, TN 37203

 

Printing Out the Forms and Filling them Out in Pen

  1. Referring to the checklists above, find the type of camper/counselor you are.
  2. All online forms and other necessary information are listed.

  3. Any forms with the "PDF" indication mean it is an online form. Click on the first online form name.
  4. The form opens in Abobe Acrobat Reader.

  5. To print the form to your default printer, click the Print Form button located in the upper right-hand corner of the form.
  6. (Microsoft Internet Explorer Users) Click the Back button in the browser toolbar to close the form and return to the checklist.
    (Netscape Users) Select File»Close from the menu bar to close the form.
  7. Fill out forms in pen.
  8. If the form has a signature field, sign the printed form in pen.
  9. Referring to the checklist, provide copies any other necessary information (ex., copy of insurance cards, doctor's notes, medical licenses, etc.).
  10. Fax all requested information to the Camp O Processing Department, Attn: Glenda Streicher at (615) 341-8814.

OR

Mail all requested information to:
Camp Okawehna Processing Department
Attn: Glenda Streicher
1633 Church St, Suite 500
Nashville, TN 37203

 


Contact Information

For more information, please contact:

Andy Parker
Camp Okawehna
1633 Church Street, Suite 500
Nashville, TN 37203
Phone: (615) 327-3061
Fax: (605) 341-8814
Email: CampO@dciinc.org


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1633 Church Street, Suite 500
Nashville, TN 37203
(615) 327-3061
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