Fillable Printable Immunization Program Public Education Materials Order Form
Fillable Printable Immunization Program Public Education Materials Order Form
Immunization Program Public Education Materials Order Form
Bureau of Immunization
Public EducationMaterials Order Form
New York State Department of Health
NYSDOH June2016Page 1
INSTRUCTIONS FOR ORDERING
•Materials are available free of cha rge to New York State r e sidents.
•Label eac h order form page w ith y our organization na me .
•Check the appropria te boxes for the quantities desire d.
•Your address MUST be completed on the label bel ow to ins ure del i very.
•Orders CANNOTbe delivered to a post office bu l k box n umber.
•Allow at leastthreewee ks for de li ver y .
•** Currently ou t of stock.
•Choo se one of two e as y wa ys to ord er :
EMAIL: B0019W@health.ny.gov
MAIL:NYSDOH Distribution Center
PO Box 343
Guilderland, NY 12084-0343
For questions a bout s hipping or publications quantitie s, call 518-675-3004.
Name:
Organization:
Address:
Bureau of Immunization
Public EducationMaterials Order Form
New York State Department of Health
NYSDOH June2016Page 2
PublicationType
Publicat ion Number
Quantity
50 100 200
General/Adult
New York State Adult Immunization RecordCard2376 (English/ S panish)
Adult Immunization Schedule (consumers)Flyer2391 (English)
Immunization Record & Signature Card (providers)Card2996 (English)
General/Childhood
New York St ate Childhood Immunization RecordCard2302 (English/ S panish)
CheckIt Out coloring bookBooklet2348 (English)
2349 (S panish)
Check It Out coloring bookSticker2408
NYS I m m unizati o n Requir eme nts fo r School
Entrance/Attendance
Flyer2370 (English)
2405 (S panish)
New York St ate Rec om m ended Childhood Vaccination
Schedule (parents)
Flyer2378 (English)
2418 (S panish)
Immunization Record & Signature Card (providers)CardDOH 2996 (English)
Protect your kids from cancer! (HPV vaccine)Brochure2108 (English)
Hepatitis
Prev ent H epat itis ABrochure1859 (English)
Protect You r Ba by for Life from Hepatitis BBrochure1807 (English)
1808 (S panish)
Don'tforget...Make Su r e Y o ur Baby Get s the Hepatit is B Sh o tPalm card2420 (English)
Living with Chronic Hepatitis B Brochure1849 (English)
1850 (S panish)
Protect You r Ba by for Life – When a Pregnant Woman Has
Hepatitis B
Fact Sheet2104
Seasonal Influenza/Pneumococcal
Disease
To order seasona l influenza and pneumococcal publications,
visit www.health.ny.govand type "seasonal influenza
education" into the search box. On the next page, click on the
heading “New York State Influenza and Pneumococcal
Prevention.”
POSTER ORDERING LIST
Poster Name
Publicat ion Number
Quantity
5 10 20
General/Adult
Protect Your Family(for pregnant women-infl uenza an d Tdap
vaccines)
2350(English)
2351 (S panish)
Bureau of Immunization
Public EducationMaterials Order Form
New York State Department of Health
NYSDOH June2016Page 3
POSTER ORDERING LIST
Poster Name
Publicat ion Number
Quantity
5 10 20
General/Childhood
Get All Your Ba by’s Shots2419 (English)
2422 (S panish)
POSTER ORDERING LIST
Poster Name
Publicat ion Number
Quantity
5 10 20
General/Childhood
NY VFC Provider2366 (English)
2367 (S panish)
A Child’s Hea lt h is as Precious as a Work of Art2375 (English)
2377 (S panish)
Controlling Communicable Disease in the Child Care Setting2198
Hepatitis
Pregnant? Ask Your Provider about Hepatitis B2421 (English)
Hepatitis A and B1842 (English)
Miscellaneous
Rash wit h Fever? ( child version, for professional use i n m edical
facilities, 11 x 17 )
2190
Rash wit h Fever? (a dult version, forprofessional us e in medical
facilities, 11 x 17 )
2191
New York State Influenza and
Pneumoco cca l Pr even ti o n
To order seasona l influenza and pneumococcal publications, vi sit
www.health.ny.gov
and type "seasonal influenza education" into the
search box. On the next page, click on the headin g “New Yor k State
Influenza and Pneumococcal Prevention.”
Bureau of Immunization
Public EducationMaterials Order Form
New York State Department of Health
NYSDOH June2016Page 4
MISCELLANEOUS ITEM ORDERING LIST
ItemType
Item Number
Quantity
50 100 200
Hepatitis
Hepatitis AMagnet1846 (English)
Hepatitis B Magnet1847 (English)
Seasonal Influenza/Pneumococcal
Disease
To order seasona l influenza and pneumococcal publications,
visit www.health.ny.govand type "seasonal influenza
education" into the search box. On the next page, click on the
heading “Seasonal Influenza Educational Materials.”
AVAILABLE ONLINE ONLY FROM THE NYSDOH
Web address
Influenza Toolkits (health car e providers, lon g term care
facilities, hospitals)
www.health.ny.gov/prevention/immunization/toolkits/
Immunization Handbook for NY S P ost-Secondary
Institutions
www.health.ny.gov/prevention/immunization/handbook/index.htm
