/ IMMUNIZATION MATERIALS ORDER FORM
SFDPH Communicable Disease Prevention Unit
101 Grove Street, Room 408, SF, CA94102
tel. 415-554-2830 fax 415-554-2579

VALID FOR SAN FRANCISCO ONLY

Please specify the quantity and language of each item (only one quantity is necessary for bilingual materials). There is no charge. Shaded areaindicates not available in that language. You may fax your request to

415-554-2579 or mail it to above address. You can now order online at .

Allow at least two (2) weeks for delivery.

Contact Information: Date Of Request: ______

Agency Name: ______Phone #______Fax#______

Contact Name: ______Email ______

Mailing Address:______Zip code______

English Spanish Chinese Clinic and Provider Materials

2013 Recommended Adult Immunization Schedule 746
2013 Recommended Pediatric & Adolescent Immunization Schedule 662
ImmunizationSite Map
8.5 x11 718
CA Immunization Record – yellow card (1000 max.) 75
GOAL! – preteen reminder postcard
bilingual,HIPPA compliant 851
Immunization Record – for medical chart 8.5 x 11 (circle Adult or Pediatric) 542
Immunization Techniques
35 minutes (DVD) 712
It’s time! – reminder postcard
bilingual, HIPPA compliant 794
Off Schedule–deferred vaccine reminder postcard, bilingual, HIPPA compliant 729
Pertussis (Whooping Cough) Kills
poster, 18x24 with photo of Mariah & Dylan
Vaccine Safety: Responding to Parents’ Top 10 concerns – 4-page brochure 917
Vaccines Work!
11 x 17 poster dph
VFC Freezer Temperature Log
two color, (circle Foor Co) 682
VFC Refrigerator Temperature Log
two color, (circle Foor Co) 682

VACCINE INFORMATION STATEMENTS: Federal Law mandates that Vaccine Information Statements (VISs) be provided every time an immunization is administered. VISs are available in multiple languages at or call 1-800-PIK-VIPS.

The SFUSD School Health Program provides health forms and Blue Cards for its schools. Call 415-575-5712 or 242-2615.

English Spanish Chinese School and Childcare Materials

California Immunization Handbook Blue Book 365
California School Immunization RecordBlue Card 101
Pre-school/Family Child Care Windows
Pink (for reading blue card) 408
School Windows
Purple (for reading blue card) 528

March 2013

English Spanish Chinese Patient / Parent Materials

Adults Need Vaccines!
brochure dph
Vaccines for Your Preteen
flyer 1054
An Ounce of Prevention
bilingual HPV brochure 852
Hepatitis B & Moms-to-Be
brochure, available in other languages ALC
Immunizations for a Healthy Pregnancy
brochure 887
Know HBV –hep B APIbrochure, available in other languages ALC
Off to College? – meningococcal disease & vaccine flyer, 8.5x11 688
Protect Your Little Onewith Baby Shots
brochurewith checklist 234
Tiene más de 50 años?
vaccine brochure for adults 50+ 260
Vaccines Adults Need
vaccine list with descriptions, 8.5x11 dph
Vaccine Safety: 10 Facts for Parents
4-page brochure, 8.5x11 916
Vaccines Work!
1 inch button pins
Warning: Sharing a Sip Could be Risky…
Meningitis water bottle brochure NOV
Whooping Cough Protect Your Baby
8.5x11 887
Whooping Cough Grandparents flyerbilingual (flip side),8.5x11 1023
English Spanish Chinese Healthy Habits
Cover Your Cough
bilingual table tent, 4.25x11 folder 784
Germ-Free Zone
bilingual, 8.5x11 (for classrooms) 789
Germs: Infect Me Not
healthy habits brochure dph
Infect Me Not
6x3magnet dph
Stop Disease – stop spread of germs information, multilingual, 6x8 780
Wash Your Hands– Protect Yourself. Prevent disease! multilingual, 6x9 819