• Family Membership Registration

    Please complete the questions below. Estimated completion time: 10 minutes (may vary depending on number of family members added)
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  • Please add your family members

  • Family Member #1

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  • Family Member #8

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  • Please provide some simple CMN (Congenital Melanocytic Nevi)-related information:

    Any information provided herein is encrypted to meet the Health Insurance Portability and Accountability act of 1996 ("HIPPA") standards, will be accessed only by NOI staff to facilitate support within the Nevus Community and potentially, make members aware of potential research opportunities, at which time additional information may be requested. Every attempt will be made to keep information disclosed confidential.
  • Please note: Nevus Outreach makes every effort to keep your information safe and confidential. By clicking a contact box above, you agree to share your basic contact information (Name, Email, City, State, Country) to facilitate connections.

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