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Private Provider Materials Ordering
Public Health Department Provider Materials Ordering







Statewide Statistics
School/Child Care
Hepatitis
Vaccines For Children






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 (100)
Adult (100)
Childhood (100)
Childhood 8.5 x 11 (50)
Other Materials International Certificate of Vaccination
(ICV)
 
Plastic Sleeves for ICV (100)  
Plastic Sleeves (100)  
Next Due Stickers (250 per pad)  
Immunization Guide Book (Redbook) 2009-2010
(Limit 2)
 
PPV Stickers (500 per roll)  
Vaccinate Before You Graduate Bookmark
Got Vaxed Bookmark  
Exemption Forms Personal  
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.
VIS Camera Ready Set
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)
The 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 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

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