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Order Form


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Order by Mail
Order Online

Opens in new windowFolic Acid Order Form
Opens in new windowFamily Planning Waiver Order Form

Materials are free and available in bulk quantities only to organizations in North Carolina.

If this is your first order, please readOpens in new windowTips for Ordering. Out-of-state requests for multiple copies cannot be honored, but a sample packet may be requested.

Order by Fax

Download and print the Opens in new windowOrder Form (62 KB), complete the information requested and fax it to 919-828-7470.

Order by Mail

Download and print the Opens in new windowOrder Form (62 KB), complete the information requested and mail it to:
Attn: Shipping Department
N.C. Healthy Start Foundation
1300 St. Mary's St., Suite 204, Raleigh, NC, 27605

Order Online

Please complete the following form and click the Submit Order button at the bottom. ( Do not hit the "Enter" key on your keyboard. Your form will be sent prematurely.

**Please allow 3 weeks for delivery**


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City

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PO Box

City

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Date Needed

Women's Health

Item

# Packs

Total Qty.

Taking Care of Me
��50 Items Per Pack

A3

Private Matters
��100 Items Per Pack

A4

It's Time to Take Care of You Poster

A5

***

Mujer Total* (Total Woman)
��25 Items Per Pack Max. Order 100

A6S

Choices: Health Matters for Women
��50 Items Per Pack

A7

Es hora de dedicarse a su salud cartel (Time to Take Care)

A8S

***

My Health Journal
��25 Items Per Pack

A9E

Mi Diario de Salud
��25 Items Per Pack

A9S

Keeping it Real
��50 Items Per Pack

A10E

VIH Una Realidad (HIV: Keeping it Real)
��50 Items Per Pack

A10S

Keeping It Real /�Saber es Poder! Poster/Cartel

A11

***

Pregnancy

Item

# Packs

Total Qty.

Our Healthy Baby's Family Album
��50 Items Per Pack

B2

What's Happening to Me? (Pregnancy Calendar)
��25 Items Per Pack

B3

If You Smoke and Are Pregnant
��50 Items Per Pack Max. Order 100

B4

Prevent Preterm Labor
��100 Items Per Pack

B5E

Prevenga el parto prematuro
��100 Items Per Pack

B5S

A Healthy Baby Begins with You Poster

B8

***

Keeping The Circle Healthy
��100 Items Per Pack Max. Order 200

B9

Text4Baby Referral Cards Eng.
��100 Items Per Pack

B10E

Text4Baby Referral Cards Span.
��100 Items Per Pack

B10S

Text4Baby Flyer Eng./Span.
��100 Items Per Pack

B11

One Child, One Community
��100 Items Per Pack

F21

Parenting and Baby Care

Item

# Packs

Total Qty.

See How We Grow
��50 Items Per Pack Max. Order 200

C1E

Observa mi crecimiento (See How We Grow)
��50 Items Per Pack Max. Order 200

C1S

Baby's Safe Sleep (Fotonovela)
��100 Items Per Pack

C2

Back to Sleep Information Sheet (English/Spanish)
��50 Items Per Pack

C4

Oh Baby! (Secondhand Smoke)
��50 Items Per Pack Max. Order 100

C6

Baby's Safe Sleep Poster

C9E

***

C�mo dormir a su beb� seguro cartel (Baby's Safe Sleep)

C9S

***

Duerma seguro a su beb�* (Your Baby's Sleep Safety) (fotonovela)
��25 Items Per Pack

C12S

Men's Health

Item

# Packs

Total Qty.

Body Maintenance Manual
��25 Items Per Pack

H1

Health Check (Medicaid)/NC Health Choice (HC/NCHC)

Item

# Packs

Total Qty.

HC/NCHC Ana Mar�a Fotonovela* (Spanish)
��50 Items Per Pack

D2S

HC/NCHC Envelope Stuffer/Volante para carta
��100 Items Per Pack

D3

HC/NCHC Fact Sheet (English/Spanish)
��100 Items Per Pack

D4

HC/NCHC Fact Sheet (D4 Folded)
��100 Items Per Pack

D4BR

HC/NCHC Poster/Cartel

D5

***

HC/NCHC Application
��100 Items Per Pack Max. Order 500

D6E

HC/NCHC Solicitud
��100 Items Per Pack Max. Order 300

D6S

Medical Home

Item

# Packs

Total Qty.

The Right Call/Siempre la llamada correcta
��100 Items Per Pack

M1

Medical Home Magnet/Im�n
��100 Items Per Pack Max. Order 500

M2

Fever/Fiebre
��100 Items Per Pack Max. Order 500

M4

Colds/El catarro
��100 Items Per Pack Max. Order 500

M5

Ear Infections/Infecciones del o�do
��100 Items Per Pack Max. Order 500

M6

Medical Home vs. ER/Su Hogar M�dico o la Sala de Emergencias
��100 Items Per Pack Max. Order 500

M7

Make Each Doctor's Visit Work for You
��100 Items Per Pack Max. Order 500

M8

Choosing a Quality Medical Home
��100 Items Per Pack Max. Order 500

M9

* English translations available at:
Mujer Total (Total Woman)
Duerma seguro a su beb� (Your Baby�s Sleep Safety)
Ana Mar�a Fotonovela

Last updated: June 2010


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