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  • About
    • Self Integrative Care
    • Carolyn Self, FNP
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    • Frequently Asked Questions
  • Services
    • Functional Medicine
      • Stepping Stones
      • Case Studies
  • Forms
    • Membership Questionnaire
    • Forms and Instructions
  • Contact
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Forms & Instructions


Members, please complete and return the following forms by clicking on the links below. Provide the requested information and click the “Submit” button at the bottom of each page.

Member Information

Medical History

Medical Symptom Questionnaire

Supplement List

Notice of Privacy Practices
The Notice of Privacy Practices is for reference and does not need to be returned.

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