Order form for MnVFC promotional materials by tpc93195


									                        Order Form
                        MnVFC Promotional Materials
Mail:         Minnesota Department of Health                       Agency
              Immunization Program
              P.O. Box 64975                                       Address
              St. Paul, MN 55164-0975

Phone:        1-800-657-3970 or 651-201-5503                       City                                     State               Zip

Fax:          651-201-5501                                         Phone                                    Contact

•     All materials are free of charge

                                                                                English        Hmong   Russian        Somali   Spanish       Vietnamese

    Concerned About the Cost of Shots?                               no limit
    Poster, 11” x 17”
                                                                                IC#141-2639                                    IC#141-2640

    Can I Get Free or Low Cost Shots for My Kids?                    no limit
    Flyer with self-screening form on the back

    Ask About Free or Low Cost Immunizations.                        no limit
    Table tent with simple message in six languages
                                                                                IC#141- 2642

    Can My Child Get Free or Low Cost Shots?
    Self-screening form (translated versions with English on the      limit 1
                                                                     of each

    Comments or questions:

                                                                                                                                  IC# 141-2643 (MDH 1/09)

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