Publication Order Form - Cancer Materials

Publications in quantities up to 200 are available free of charge to New York State residents and organizations. To place an order, please circle the quantity desired and fill out the requestor information below. Forms may be faxed or mailed as specified below. Additionally, requests can be made via e-mail to the address below. When requesting materials by e-mail, please include all information listed on the form for each publication ordered.

Contact information

Requestor Information

Name: _______________________________________________________

Organization: __________________________________________________

Address: _____________________________________________________

City, State, Zip Code: ___________________________________________

Telephone Number: ______________________ Date:_________________

Title Type Language Code Number Indicate Quantity –(maximum amount 200 copies per title)
Get Fit! A new test for colorectal cancer Pamphlet English 0343 50 100 200    
Get Fit! A new test for colorectal cancer Poster English 0344 5 10 25 50  
Ovarian Cancer: What You Need To Know Pamphlet English 0438 10 25 50 100 200
Spanish 0439 10 25 50 100 200
Chinese 0391 10 25 50 100 200
Russian 0392 10 25 50 100 200
New York State Cares About Ovarian Cancer Poster
11" x 17"		 English 0345 10 25 50 100  
New York State Cares About Ovarian Cancer Poster English 0467 10 25 50 100 200
Spanish 0468 10 25 50 100  
Prostate Cancer: What All Men Must Know Pamphlet English 0414 10 25 50 100 200
Spanish 0428 10 25 50 100 200
Russian 0461 10 25 50 100 200
Chinese 0430 10 25 50 100 200
French 0429 10 25 50 100 200
Prostate Cancer
(African-American)		 Brochure English 0383 10 25 50 100  
Prostate Cancer
(African-American)		 Palm Card English 0384 10 25 50 100  
Prostate Cancer
(African-American)		 Poster - Horizontal English 0385 10 25 50 100  
Prostate Cancer
(African-American )		 Poster - Vertical English 0386 10 25 50 100  
Colorectal Cancer True/False Poster English 0381 1 3 5    
Colorectal Cancer True/False Poster Spanish 0382 1 3 5    
Breast Cancer-A Woman's Guide to Diagnosis and Treatment Booklet English 0401 10 25 50 100 200
Spanish 0402 10 25 50 100 200
Chinese 0403 10 25 50 100 200
Russian 0404 10 25 50 100 200
Breast Cancer-Reconstruction Is It Right for You Fact Sheet English 0426 10 25 50 100 200
Breast Screenings Help Save Lives Pamphlet English 0418 10 25 50 100 200
Spanish 0419 10 25 50 100 200
Russian 0465 10 25 50 100 200
Chinese 0466 10 25 50 100 200
What is Colposcopy Pamphlet English 0413 10 25 50 100 200
Spanish 0441 10 25 50 100 200
Russian 0464 10 25 50 100 200
Chinese 0463 10 25 50 100 200
Spanish 0439 10 25 50 100 200
Save the Skin Your Child is In…Help Prevent Skin Cancer Pamphlet English 0472 1 10 25 50 100
French 0389 1 10 25    
Spanish 0390 1 10 25    
Save the Skin Your Child is In…Help Prevent skin Cancer Poster English 0474 1 10 25    
French 0387 1 10 25    
Spanish 0388 1 10 25    
Save the Skin Your Child is In…Help Prevent skin Cancer Kids Poster English 0393 1 10 25    
Have You Had Cancer Treatment? Brochure English 0399 1 5 10    

Revised July 2008