MISSOURI POISON PREVENTION MATERIALS ORDER FORM by gdf57j

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									              MISSOURI POISON PREVENTION MATERIALS ORDER FORM

Name _________________________________ Phone number ____________________
Address _______________________________ City/State/Zip __________________________
*County _______________________________
_____________________________________________________________________________________

                                                          Price                            Amount

Sample Packet (One per mailing address)                   Free                             _______

Sheet of Mr. Yuk stickers (10 stickers/sheet)             .10each or $10.00/100            _______

Mr. Yuk in Missouri Magnet                                .50each or $50.00/100            _______
       (w/ “Emergency Action for Poisoning” card)

Brochures
       Toxic and Non-Toxic Plants                         .15each or $15/100               _______
       Stinging Insects, Spiders and Snakes               .15each or $15/100               _______
       Carbon Monoxide-the Silent Killer                  .15each or $15/100               _______
       Inhalants: Not a Fad-A Deadly Fact                 .15each or $15/100               _______
       Poison Prevention for Seniors                      .15each or $15/100               _______
       Look Out for Poison Look-Alikes                    .15each or $15/100               _______
       Taking Your Medication Correctly                   .15each or $15/100               _______

‘Mistaken Identities’ Mini-Poster                         One Free                         _______
        (Color 11”X17” – shows look-a-like products)      Additional $.50 each             _______

Coloring Book : “Poison Prevention Activity Book”         .30each or $30/100               _______

Spike’s Poison Prevention Adventure DVD Program           One Free                         _______

Your Poison Center/First Aid Brochures                    50 Free (Additional $2.00/50)    _______
Poison Help Magnets                                       50 Free (Additional $2.00/50)    _______
Poison Help Wallet Cards                                  50 Free (Additional $2.00/50)    _______
Poison Help Phone Stickers                                50 Free (Additional $2.00/50)    _______
                                          TOTAL:                                           _______



**If you are a designated MUA or FQHC, please call the Missouri Poison Center for your order form.**
               In the St. Louis area, call (314) 772-8300, or call toll-free at 1-866-612-5719


               For more information, please contact Tony at the Missouri Poison Center.
              In the St. Louis area, call (314) 772-8300, or call toll-free at 1-866-612-5719.
                           You may fax your order to 314-612-5740, or mail to:
              Missouri Poison Center, 7980 Clayton Road, Suite 200, St. Louis, MO 63117



          Check out our Web site at www.cardinalglennon.com under support services.
                Click on Poison Center for downloadable brochures and games.

								
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