Brochure Request Form

1. Contact Information

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Name:

 

 

   

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City/State/ZIP:

 

    

 

 

 

 

Date of Birth:

 

 

What's this?

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5.
Question - Not Required - Diet, Nutrition, and Inflammatory Bowel Disease

6.
Question - Not Required - Facts about IBD (Disease overview, History, & Statistics)

7.
Question - Not Required - IBD Symptom Tracker (Can help patients monitor their IBD and includes sample questions to ask their healthcare provider)

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Question - Not Required - IBD vs. Irritable Bowel Syndrome (IBS)

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Question - Not Required - Education & Support Brochure for Patient with IBD

10.
Question - Not Required - Education & Support for Pediatric Patients with IBD (Palm Card)

11.
Question - Not Required - Living with Crohn's Disease

12.
Question - Not Required - Living with Ulcerative Colitis

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Question - Not Required - Diagnosing and Monitoring IBD

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Question - Not Required - Managing Flares & other IBD Symptoms

15.
Question - Not Required - Surgery for Crohn's Disease and Ulcerative Colitis

16.
Question - Not Required - Understanding IBD Medications and Side Effects

17.
Question - Not Required - Comic Book: Pete Learns All About Crohn's & Colitis

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Question - Not Required - IBD & Me Activity Book

19.
Question - Not Required - Crohn's disease & Ulcerative Colitis: A Guide for Parents

20.
Question - Not Required - Crohn's disease & Ulcerative Colitis: A Guide for Teachers & Other School Personnel

21.
Question - Not Required - A Guide for Teens with IBD

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Question - Not Required - Making Treatment Decisions - (For Kids and Teens)

23.
Question - Not Required - The Importance of Listening to Your Body - (For Kids and Teens)

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Question - Not Required - Short Bowel Syndrome and Crohn's Disease

25.
Question - Not Required - Vivir con la Enfermedad de Crohn

26.
Question - Not Required - Vivir Con la Colitis Ulcerosa

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Question - Not Required - Medicamentos para la Ell y cuáles son sus efectos

28.
Question - Not Required - Guía para padres y cuidadores pediátricos (Guide for Parents and Pediatric Caregivers)

29.
Question - Not Required - Fact sheets (One copy of each fact sheet--reproduction permitted.):

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