Quantities vary and are often limited. Orders will be filled accordingly
Women’s Health Educational Materials ORDER FORM Name: ___________________________________________________________________ NC Agency Name: ____________...
Women’s Health Educational Materials ORDER FORM Name: ___________________________________________________________________ NC Agency Name: ____________________________________________________________________ NC Agency Type:
_____ Local Health Department (LHD)
_____ Teen Pregnancy Prevention Program (TPPI)
_____Other Phone Number: ______________________________________________________________________ Mailing Address: _____________________________________________________________________ City, State, Zip Code/State Courier Number Mail or Fax (Please send ONLY the face page and the pages containing orders) to: NCDHHS Women’s Health Branch 1929 Mail Service Center Raleigh, NC 27699-1929 Courier #56-23-01 Fax number: (919) 870-4827 Office Use Only
Shipped Date: __________________
Quantities vary and are often limited. Orders will be filled accordingly.
Revised 7/11/13
Family Planning & Preconception Health Educational Materials Abstinence Am I Ready for Sex? Facts about Abstinence Encouraging Abstinence: Ten Tips for Parents Sex: 10 Best Reasons to Wait Talking Abstinence Adolescent Puberty Birth Control: Talking with your Parents Female Facts Menstruation Puberty Facts Birth Control Methods Birth Control Facts Facts About Emergency Contraception Facts About Birth Control Implants Facts About Birth Control Pills (“The Pill”) Facts About Condoms (“Rubbers”) Facts About Contraceptive Shots (formerly Facts About Depo Provera) Facts About Diaphragms Facts About Intrauterine Contraceptives (IUCs) Facts About Mirena “IUD” Facts About Natural Family Planning Facts About NuvaRing Facts About the Contraceptive Patch
Available to (Agency Code)
Publication Unit English Spanish Type Size/Limit Quantity Quantity
Facts About Spermicides Family Planning Methods/Métodos de Planificación Familiar Gynecological Problems/STDs Bacterial Vaginosis Genital Warts and the Human Papilloma Virus (HPV) HIV: Keeping it Real/VIH Una Realidad HIV Keeping it Real/ ¡Saber es poder! STD Facts Trichomoniasis (also known as “trich”)
LHD; TPPI All
Fact Sheet Brochure
100/pad 50/pack; Limit 200
FP 0022
LHD; TPPI LHD; TPPI
Brochure Brochure
100/pack 100/pack
FP 0024 FP 0027
All All LHD; TPPI LHD; TPPI
Brochure Flyer Brochure Brochure
50/pack 25/pack 50/pack 100/pack
FP 0028 FP 0029
Vaginal Discharge Yeast Infection
LHD; TPPI LHD; TPPI LHD; TPPI
Brochure Brochure Brochure
100/pack 100/pack
FP 0030 FP 0031
LHD; TPPI LHD; TPPI Available from 919-707-5631
Brochure Brochure
50/pack
LHD; TPPI LHD; TPPI LHD; TPPI
Brochure Brochure Brochure
50/pack 50/pack 50/pack
All
Brochure
25/pack
LHD; TPPI LHD; TPPI LHD; TPPI
Brochure Brochure Brochure
50/pack 50/pack 50/pack
FP 0101 FP 0100 FP 0102
All All All
Booklet Poster Poster
25/pack
FP 0105
Infertility/ Genetic Counseling Evaluating Infertility Genetic Services, Your Questions Answered
Male Involvement Male Facts Male Self-Exam If You Are A Man ... Understanding Birth Control Body Maintenance Manual/ Manual de Mantenimiento del Cuerpo Nutrition/Weight Management Weight and Men Weight and Women What’s Your BMI? Facts about Body Mass Index Healthy Habits/Mujer, Madre y Amiga Is Your Weight Healthy/¿Es Su Peso Saludable? BMI Chart (Laminated)
Limit 2
N/A
FP 0032
FP 0035 FP 0036 FP 0039
Preconception Health/Reproductive Life Planning Am You Ready to Be a Mom? Am You Ready to Be a Dad? Are You Ready? Sex and Your Future/ ¿Qué harás en tu futuro?
LHD; TPPI LHD; TPPI All
Brochure Brochure Brochure
50/pack 50/pack 50/pack
FP 0103 FP 0104 FP 0106
Choices: Health Matters For Women It’s Time to take Care of You /Es hora de dedicarse a su salud cartel (Time to take care)
All All
Brochure Poster
50/pack
Private Matters: My Monthly Period Mujer Total
All All
Wallet Card Brochure
My Health Journal/ Mi Diario de Salud Take Care of Yourself (includes folic acid message) Show Your Love (African American audience; includes folic acid message) Show Your Love (African American audience; includes folic acid message) Folic Acid: Mujer Prevenida Vale por Dos (Fotonovella) Folic Acid: Take Control of Your Life, Take Care of Yourself Folic Acid: Multivitamins For, For Your Baby, For Life Folic Acid: The Healthier I Am, the Happier I Am Folic Acid: Busy Women’s Guide to Multivitamins/Guía para la mujer Folic Acid: Mujer Prevenida Vale por Dos Folic Acid: Combo DVD 2 English titles (6 min; 9 min); 2 Spanish titles 8 min; 14 min) Folic Acid: Both of Us
All All
Brochure Brochure
100/pack 25/pack; Limit 100 25/pack
All
4” x 9” Card
100/pack
All All
11” x 16” Poster Brochure
100/pack
All
4”x 9” Card
100/pack
N/A
All
4”x 9” Card
100/pack
N/A
All All
4”x 9” Card 3” x 5” card
100/pack 100/pack
All All
Poster DVD
All
Poster
N/A
N/A N/A
N/A
N/A Limit 1
Maternal Health Educational Materials Diabetes in Pregnancy Gestational Diabetes: Before the Baby, After the Baby My Plate for Gestational Diabetes
Available to (Agency Code)
Publication Type
Unit Size/Limit
All
Fact Sheet
Limit 100
All
Instruction Sheet Bilingual Booklet
50/tear-off pad
A Photonovel: Embarazo y Diabetes/Pregnancy and Diabetes Lead Are You Pregnant? Protect Your Baby from Lead Poisoning General Maternal Health Healthy Mom, Healthy Baby Our Healthy Baby’s Family Album My Pregnancy Calendar/ El Calendario de Mi Embarazo If You Smoke and Are Pregnant
All
All
English Quantity
Spanish Quantity
MH 4070
MH 4080
Limit 100
All All All
Booklet Booklet
All
Brochure
Prevent Preterm Labor / Prevenga el parto prematuro A Healthy Baby Begins with You Keeping the Circle Healthy Parenting & Baby See How We Grow/Observa mi crecimiento
All
Office Use Only (Billing Code)
MH 4096
MH 4011 50/pack 25/pack
N/A
N/A
Wallet Card
50/pack Limit 200 100/pack
All All
Poster Brochure
100/pack
All
Flip Chart
Baby’s Safe Sleep Back to Sleep Information Oh Baby! (Secondhand Smoke)
All All All
Booklet Fact Sheet Brochure
50/pack Limit 200 100/pack 50/pad 50/pack
Baby’s Safe Sleep Tips/Duerma Seguro a Su Bebé Consejos Baby’s Safe Sleep/Cómo dormer a su bebé seguro cartel My Baby’s Safe Sleep Checklist Infant Safe Sleep Checklist/Lista de Control para un Sueño Seguro Cartel
All
Brochure
50/pack
All
Poster
All All
Brochure Poster
50/pack
N/A? N/A
Postpartum Taking Care of You: Your Postpartum Health & Visit
Pregnancy Care Management Pregnancy Care Management Text For Baby Text4Baby: Dual Language Flyer Text4Baby: Acrylic Referral Card Holder Text4Baby: Referral Cards Text4Baby: African American Text4Baby: Caucasian Text4Baby: Native American Text4Baby: Latino
Sickle Cell Educational Materials
Available to (Agency Code)
Publication Type
About Sickle Cell Disease and Sickle Cell Trait (multicultural) About Sickle Cell Disease and Sickle Cell Trait
All All
Brochure 21828 Brochure
A Parent's Handbook for Sickle Cell Disease (part I) A Parent's Handbook for Sickle Cell Disease (part II) A Teacher Can Make A Difference A Test to Save Your Baby's Life NC Sickle Cell Syndrome Program - 2005 edition
All
Brochure
All
Brochure
All All All
100/pack N/A N/A N/A N/A
Unit Size/Limit
38992 ENGLISH
Out Of Stock Limit 20
Brochure Brochure
English Quantity
Spanish Quantity
4066 4067 4068 4062 4063 4064 4065
Office Use Only (Billing Code)
N/A
SC 0004m/E
39339/65564 SPANISH N/A
SC 0004
N/A
SC 0002
SC 0001
SC 0025 SC 0024 SC 0005
Physicians Reference For the Management of Sickle Cell & Other Abnormal Hemoglobins (Must submit name and facility address of Provider.)
Medical Providers Only
Sickle Cell Testing for Newborns (English)
All
Answers to Questions About Sickle Cell Disease Transfusion Can Reduce The Risk of Strokes In Sickle Cell Anemia Pre-natal Tests For Sickle Cell Anemia A Bone Marrow Transplant Cures Sickle Cell Anemia Penicillin Pills Prevent Fatal Infections Sickle Cell Trait And Rigorous Exercise In the Military Sickle Cell Anemia and Fetal hemoglobin A Substance That Sparks A Gene That Could Ease Sickle Cell Anemia A Test That may Predict Strokes Hydroxyurea - The First Effective Treatment For Sickle Cell Anemia An Experimental Transplant Cures a Teenagers Sickle Cell Anemia Procedure Enables Sickle Cell Trait Couples To have Babies W/Out Sickle Cell Trait or Sickle Cell Anemia A Low Salt Treatment
All All All All All All All All All All All All All