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Alumni Update Form

Please allow one to two days for us to post the information.

Submitting this form only updates your contact information with the Alumni Affairs office. To also update your practice listing on our website, please click List My Practice Online and complete the online form.


Practitioner Information:
*required  
*Full Name:
Degree(s) (ND, LAc.):
Practice Name:
Fax:
*Phone:
Extension:
*Email:
 
Street Address:
City:
State:
Zip:
   
Website:
Description:
The above information is:

 

Privacy compliance
. By submitting this form online, you are acknowledging that you have read our privacy statement and understand its terms.


If you have any special needs, please call the Office of Student and Alumni Affairs: (503) 552-1625