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CCIC Online Order Form

Immunization Palm Cards

Fill out and submit the online order form below to request the following items from CCIC:

 

- Immunization Palm Cards for healthcare workers:

 

*Please note: The 2009 IZ Palm Cards are in the final stages of production, but you can place your order TODAY!*

  • 2009 Routine Childhood Immunization Schedule Palm Cards
  • 2009 Childhood Immunization Screening Palm Cards
  • 2009 Routine Adolescent Immunization Schedule Palm Cards
  • 2009-2010 School Immunization Regulations Palm Cards

- *NEW* Parent Outreach Brochures

Includes information on the importance of vaccines, vaccine safety, resources for low-cost vaccinations and an easy-to-read infant immunization schedule in both English and Spanish.  Check out the brochure.

 

- Other resources and promotional items

* First Name

* Last Name

* Organization

* Mailing Address

* Email

* Phone
Please answer the following questions before placing your order.

* How did you hear about our website? (Please check all that apply. If you choose "Other," please elaborate in the box provided)

CCIC Coalition Member

Local Immunization Coalition Meeting

CDPHE Representative

The Children's Hospital Representative

CCIC Promotional Materials

Other

Other

* What other tools, resources or web pages have you used on the CCIC website? (Please check all that apply)

Vaccine-Preventable Disease Reports

Immunization-related News Videos

Immunization Referral List

Parents' Page (includes resources, vaccine safety information, disease information, fears and myths, and state immunization recommendations)

Spanish Parents' Page

Providers' Page (includes resources and links)

CCIC Educational Opportunities (Speaker and Seminar Details)

Coalition Member Page (includes meeting minutes)

Public Policy Page

Events Calendar (includes the opportunity to submit events to be added to CCIC Online Calendar)
 

* What other tools and/or resources would you like added to the CCIC website? (If none, please state 'none' in the box)
Thank you for your feedback! Please continue with your order below.
I would like to order the following:
2009 Routine Childhood Immunization Schedule Palm Cards

25 Cards

50 Cards

100 Cards
2009 Childhood Immunization Screening Palm Cards

25 Cards

50 Cards

100 Cards
2009 Routine Adolescent Immunization Schedule Palm Cards

25 Cards

50 Cards

100 Cards
2009-2010 School Immunization Regulations Palm Cards

25 Cards

50 Cards

100 Cards
NEW Parent Outreach Brochures

25 Brochures

50 Brochures

100 Brochures

200 Brochures

* Required Fields
 

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