Promotional Materials - Professional Education/Materials

Private Provider Materials Ordering
Public Health Department Provider Materials Ordering

PUBLIC HEALTH DEPARTMENT RESOURCE ORDER FORM
Name: Organization: Address: City:	Date: Phone: Fax: State: Zip:

Please order the number of packages needed:		English	Spanish
Record Cards	Adult Record Card (50)
	Pink USIR (250)
	Lifetime Personal Record (Yellow Card) (50)
Schedule Cards	Adolescent (Temporarily out of stock) (100)
	Adult (100)
	Childhood (100)
	Childhood 8.5 x 11 (50)
Other Materials	Perinatal Hepatitis B Lab Testing Form (individual forms)
	International Certificate of Vaccination (ICV)
	Plastic Sleeves for ICV (100)
	Plastic Sleeves (100)
	Next Due Stickers (250 per pad)
	PPV Stickers (500 per roll)
	VFC Stickers (100 per roll)
Exemption Forms	Personal
Exemption Forms	Religious
Posters	Adult Schedule Poster 11 x 17
	Got Vaxed Poster Question Mark 14 x 20
	Got Vaxed Poster Teenagers 14 x 20
	Get the Flu Vaccine Poster 11 x 17
	Preteen Doctor Visit 12 x 20
	Vaccinate Before you Graduate 11 x 17
Hepatitis B Vaccine Initiative Providers ONLY NEW	Hepatitis B Vaccine Initiative Flyer Generic
	Hepatitis B Vaccine Initiative Flyer-Salt Lake Co.
	Hepatitis B Vaccine Initiative Flyer-Utah Co.
	Hepatitis B Vaccine Initiative Flyer-Weber/Morgan Co.
Brochures	Get the Flu Vaccine (50)
	Hepatitis A What You Should Know (50)
	Hepatitis B Stop the Spread (50)
	Older Adults Need Shots (100)
	Planning a Trip (100)
	Preteen Doctor Visit (100)
	Protect Yourself Adult (100)
	Questions & Answers (25)
	USIIS Parent's Guide (100)
	Utah School Immunization Rule (100)
	Vaccinate Before you Graduate (100)
	Vaccine Safety (50)
Tearpads	VFC Information Tearpad (English and Spanish combined) (50)
Please verify your order by entering the random letters (case sensitive) displayed in this image:
Contact Lisa Young with any questions (801) 538-9101 or email Include quantities that will be sufficient for a three month period. PLEASE ALLOW 2-3 WEEKS FOR DELIVERY