FAX BACK ORDER FORM

Emergency Contraception Hotline Materials

The following materials can be ordered at no charge while supplies last by faxing this form to the Association of Reproductive Health Professionals (ARHP). Please call Natalia Barolin if you have any questions about the materials.

General Materials:

    _____  Wallet cards (English)

    _____  Laminated "receptionist telephone protocol" cards (English)

    _____  Postcards of the condom

8 1/2" x 11" public service announcements (PSAs)

    _____  of the telephone

    _____  of the pill pack

    _____  of the condom

Posters

    _____  of the condom

    _____  of the telephone

New! Materials for Diverse Audiences:

African-American Communities

    _____  Brochures

    _____  Postcards

    _____  Posters

Spanish-Speaking Communities

    _____  Spanish Wallet Cards

    _____  Spanish Laminated "receptionist telephone protocol" cards

Please send these materials to:

Name              ________________________________

Organization    ________________________________

Address          ________________________________

                       ________________________________

Phone             ________________________________