Diabetes Prevention and Control Program - Publication Order Form
- The "Diabetes Publication Order Form" also exists in PDF format (PDF, 19KB, 2pg.)
Quantities of the publications listed on this sheet 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, mailed or e-mailed as specified below.
- Fax: (518) 465-0432
- Mail: New York State Department of Health, Distribution Center, 21 Simmons Lane, Menands, NY 12204
- E-mail: b0019w@health.state.ny.us
Requestor Information
| Name: | ______________________________________________________ |
|---|---|
| Organization: | ______________________________________________________ |
| Address: | ______________________________________________________ |
| City, State, ZIP Code: | ______________________________________________________ |
| Telephone Number: | ______________________________________________________ |
| Date: | ______________________________________________________ |
Would you like a copy of our publication catalog? (circle one)
- Yes
- No
| Title | Type | Language | Code Number | Circle Quantity | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Household Sharps: How to Dispose of Them Properly | Brochure | English | 0909* | - | 5 | 10 | 25 | 50 | 100 | |
| Spanish | 0941* | - | 5 | 10 | 25 | 50 | 100 | |||
| Hello Neighbor (Hola Vecino) | Cookbook | English | 0913 | 1 | - | - | 25 | 50 | - | |
| Spanish | 0914 | 1 | - | - | 25 | 50 | - | |||
| It's Never Too Early to Prevent Diabetes. A Lifetime of Small Steps for a Healthy Family | Flyer | English | 0921 | 1 | - | - | 25 | 50 | - | |
| Diabetes Management Guidelines for Adult Diabetes Care | Guidance Document | English | 0923* | - | 5 | 10 | 25 | 50 | 100 | |
| Diabetes Mellitus Flow Sheet | Chart Tool | English | 0924* | - | 5 | 10 | 25 | 50 | 100 | |
| Manage Your Diabetes For A Healthy Life | Brochure | English | 0925* | - | 5 | 10 | 25 | 50 | 100 | |
| Manage Your Diabetes For A Healthy Life | Poster | English | 0926* | 1 | 5 | 10 | - | - | - | |
| Administering Glucagon (One Page Summary) | Poster | English | 0928* | 1 | 5 | 10 | - | - | - | |
| You Have the Power To Prevent Type 2 Diabetes & "Healthy Plate" Food Choice Guide |
Lifestyle Modification Tool |
English | 0929* | - | 5 | 10 | 25 | 50 | 100 | |
| Eye Examination Report for Diabetes | Documentation Tool | English | 0930* | - | 5 | 10 | 25 | 50 | 100 | |
| Am I at Risk for Type 2 Diabetes? | Booklet | English | 0932 | - | 5 | 10 | 25 | 50 | 100 | |
| Your Game Plan for Preventing Type 2 Diabetes | Booklet | English | 0933 | - | 5 | 10 | 25 | 50 | 100 | |
| Helping Your Overweight Child | Booklet | English | 0934 | - | 5 | 10 | 25 | 50 | 100 | |
| Lower Your Risk for Type 2 Diabetes – Tips for Kids | Tip Sheet | English | 0936* | - | 5 | 10 | 25 | 50 | 100 | |
| Personal Diabetes Care Card | Wallet Card | English | 0942* | - | 5 | 10 | 25 | 50 | 100 | |
| Spanish | 0907* | - | 5 | 10 | 25 | 50 | 100 | |||
| Children with Diabetes, A Resource Guide for Families and Schools | Book | English | 0944* | 1 | 5 | 10 | - | - | - | |
| 1 carton (38 books) | ||||||||||
| Diabetes Foot Poster (for Providers - Remove Shoes and Socks) | Poster | English | 0946* | 1 | 5 | 10 | - | - | - | |
| Spanish | 0946* | 1 | 5 | 10 | - | - | - | |||
| Diabetes Surveillance in New York State – 1997-2004 | Booklet | English | 0947* | 1 | 5 | 10 | 25 | - | - | |
| BMI Chart for Boys Ages 2-20 (50/pad) | Chart Tool | English | 4948* | 1 | - | - | - | - | - | |
| BMI Chart for Girls Ages 2-20 (50/pad) | Chart Tool | English | 4949* | 1 | - | - | - | - | - | |
| Pediatric/Adolescent BMI Calculator Wheel | Health Care Provider Tool |
English | 4950* | 1 | 5 | 10 | - | - | - | |
| AAP Recommendations for Prevention of Pediatric Overweight and Obesity - Steps to Calculate BMI |
Guidance Tool | English | 4951* | 1 | 5 | 10 | - | - | - | |
| Take Charge of Your Diabetes | Booklet | English | 6915 | 1 | 5 | 10 | 25 | - | - | |
| Spanish | 0920 | 1 | 5 | 10 | 25 | - | - | |||
| How Do You Control Your Diabetes? Don't Panic: ESAP Can Help! | Brochure | English | 9458* | - | 5 | 10 | 25 | 50 | 100 | |
| Spanish | 9459* | - | 5 | 10 | 25 | 50 | 100 | |||
| Chinese | 9460* | - | 5 | 10 | 25 | 50 | 100 | |||
| How Can You Dispose of Used Sharps Safely? | Poster | English | 9461 | 1 | 5 | 10 | - | - | - | |
| Spanish | 9462 | 1 | 5 | 10 | - | - | - | |||
| Chinese | 9463 | 1 | 5 | 10 | - | - | - | |||
| How Can You Dispose of Used Sharps Safely? | Easel Counter Top Display |
English | 9464 | - | 5 | 10 | 25 | 50 | 100 | |
| Spanish | 9465 | - | 5 | 10 | 25 | 50 | 100 | |||
| Chinese | 9466 | - | 5 | 10 | 25 | 50 | 100 | |||