Aug 24, 2017 - To order, complete this form and submit it by mail or email to: ⢠Mailing address: NYS DOH Distribution
COMMUNICABLE DISEASE FORM FOR TICK-BORNE & MOSQUITO-BORNE MATERIALS The New York State Department of Health offers limited quantities of free tick-borne and mosquitoborne disease educational materials to New York State (NYS) residents and organizations. To order, complete this form and submit it by mail or email to: •
Mailing address: NYS DOH Distribution Center PO Box 343 Guilderland, NY 12084
•
Email address:
[email protected]
Please allow 2 to 3 weeks for delivery.
Last Update 8/24/2017
----------------------------------------------------------------------------------------------------------------------------- --------------------------ITEM # TITLE (and language if other than English) TYPE QUANTITY (Circle)
(Circle)
Tick-borne Disease Materials: 2811 How to Safely Remove a Tick* (2” x 5”) 2810 All About Ticks: A Workbook for Kids & Their Parents 2815 New York State Tick ID Card (2” x 3½”) 2813 Ticks & Lyme Disease Brochure* 2737 Health Advisory- Tick and Insect Repellents PP12 Warning – Ticks in the Area May Cause Lyme Health Care Provider Education on Tick-borne Disease: 2823 Diagnosing Tick-borne Disease
Card Book Palm Card Brochure Brochure Metal Sign
1 1 1 1 1 1
10 10 10 10 10 10
50 50 50 50 50
100 100 200 300 100 100 200 100 200 300
Laminated sheet
1 10 50 100 200 300
Brochure Magnet Brochure
1 10 50 100 150 200 1 10 50 100 200 1 10 50 100 200 300
Environmental Control 2738 Anvil® and Mosquito Control 2740 Malathion and Mosquito Control 2757 Protect Your Home Against Mosquitoes (17” x 22”) 2759 Protect Your Home Against Mosquitoes (Spanish) 2723 Reducing Pesticide Exposure 2739 Scourge® and Mosquito Control 2750 What Do I Do if There is Spraying in My Community?
Fact sheet Fact sheet Poster Poster Brochure Fact sheet Fact sheet
1 1 1 1 1 1 1
10 10 10 10 10 10 10
50 50 50 50 50 50 50
West Nile Virus (WNV) 2741 Insecticide Use to Prevent WNV *– (For Providers) 2747 WNV: Do Mosquitoes Love Your Home and Yard? 2746 WNV: Frequently Asked Questions 2742 WNV Information for Outdoor Workers 2751 WNV: Senior Citizens 2748 WNV: Suggested Community Activities PP67 WNV and Transplant Recipients PP70 WNV is a Risk You Can Do Something About (Spanish)
Fact sheet Fact sheet Fact sheet Fact sheet Fact sheet Fact sheet Brochure Palm Card
1 1 1 1 1 1 1 1
10 10 10 10 10 10 10 10
50 100 200 50 100 200 50 100 200 50 100 200 50 100 200 50 100 200 50 100 150 100 200
Mosquito-borne Disease Materials: 2731 2733 2732
Mosquitoes & Disease* Mosquitoes & Diseases Mosquitoes & Diseases (Spanish)*
100 100 100 100
150 200 300 200 200
100 150 100 200 300
300 300 300 300 300 300 200
Zika Virus 13010 Zika: Pregnancy Travel Advisory* 13011 Zika: Pregnancy Travel Advisory (Spanish)*
Poster Poster
1 10 50 150 1 10 50
Mosquito & Tick-borne Materials: 2714 2761 2816 2817 2749 2765
Protect Yourself Against Mosquito & Tick Bites Flyer Protect Yourself Against Mosquito & Tick Bites*(17”x11”) Poster Protect Yourself Against Mosquito & Tick Bites (Spanish) Flyer Protect Yourself Against Mosquito & Tick Bites (Spanish) Poster Tick & Insect Repellent: Deciding on their Use* Brochure Tick & Insect Repellent: Deciding on their Use (Spanish)*Brochure
1 1 1 1 1 1
10 10 10 10 10 10
50 100 200 50 50 50 100 200 300 50 50 100 200 300
Additional materials available online: How to Remove a Tick* How to Remove a Tick (Video)* NYSDOH Tick Videos and More*
Please complete legibly. Illegible or incomplete information will affect the ability to send your requested materials. Requestor’s Name: Organization: Street Address: (Note: no delivery to Post Office Boxes) City/State/Zip: Telephone Number: Email Address: Date of order:
* Click title to view and/or print material. Additional free NYS Department of Health educational materials available: • For rabies, go to www.health.ny.gov/forms/order_forms/rabies.pdf • Other health matters, go to www.health.ny.gov/publications/4208/
