Kaiser Permanente Southern California
Weight Management Health Education Resources
(Provided by Southern California Regional Community Benefit and Health Education)
Ordering Information
The health education materials listed below are available to community based organizations who are interested in incorporating them into their weight management programs. For non-profit organizations, materials are available for free. Kaiser Permanente departments can also order free of charge to distribute exclusivelyat community events or to community providers, parents, etc. For KP member distribution,order materials through your local KP health education department. Please fax completed forms to Martha Valencia, (626) 564-3647. For questions, call (626) 564-3600.
STEP 1: Ordering and Shipping Information (please complete all sections)
Organization: / Name: / Title:Phone: / Email: / Date:
Complete shipping address
Intended use of materials:
A. Talk/Lecture Patient Education Class Health Fair Other ______
B. Target audience (MDs, patients, parents, teachers, teens, age ranges,?): ______
C. Estimated number of target audience:
Please check your affiliation: TCE/HEAC Grantee HEAL GranteeSchool
Community Clinic PublicHospital Other ______
Is organization under non-profit status? Yes No
STEP 2: Sharing Agreement (required to complete your order)
The permission to use the posters/magnets, BMI wheels, and health education materials on this order form is contingent upon the following:
- The Kaiser Permanente (SCPMG and TPMG) is the owner and holds the copyright of all materials.
- You understand that you have limited, non-exclusive, non-transferable rights to distribute these materials within your organization, and they can not be photocopied, sold or given to another organization.
- The materials enclosed are not to be used to develop any Internet sites nor can they be adapted for or placed on any Internet site (except Kaiser Permanente sites).
- You understand that Kaiser Permanente is not responsible for notifying you when adaptations or updates are made by them to the materials.
- By agreeing to the terms stated herein and using the materials, your organization and its health care providers will assume full responsibility for the content in all cases involved in litigation.
- This agreement may be terminated without cause by Kaiser Permanente, upon 30 days written notice.
- Permission will not be granted toreproduce the layout, photos, graphics, or illustrations.
- You indicate, with your name/signature below, that you are in agreement with the conditions set forth in this letter.
I have read the above information and I agree to abide by the conditions set forth above concerning our use of the Kaiser Permanente health education materials listed on the order form, which I order.______
SignatureDate
______
Title
STEP 3: Ordering Information / Order # / Description / Quantity (# Units)Get More Energy!
Exam room poster / 9118-0002-01 English
9118-0003-01 Spanish / Large, colorful exam room poster with color photos of active kids. 4 key messages & readiness to change tool. / ___English $11.29 for 10
___Spanish $11.29 for 10
Get More Energy!Magnet / 8036000 English / Smaller 4”x 6” version of the poster, without readiness to change tool. / ___ English $17.20 for 25
BMI Wheel / 9127-0001-01 / Handy wheel for providers, nurses, etc. to instantly calculates BMI values. / ___ Wheels $2.63 each
Breastfeeding: Growing Up With KP Kids PDF / MH-1037 English
MH-1045 Spanish
MH-1061 Armenian
MH-1053 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for infants. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Starting Solid Foods 4-6 Months: Growing Up With KP Kids PDF / MH-1038 English
MH-1046 Spanish
MH-1062 Armenian
MH-1054 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for babies 4-6 months. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Feeding Your Baby 6-12 Months: Growing Up With KP Kids PDF / MH-1039 English
MH-1047 Spanish
MH-1063 Armenian
MH-1055 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for babies 6-12 months. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Ages 1-3 Years: Growing Up With KP Kids PDF / MH-1040 English
MH-1048 Spanish
MH-1064 Armenian
MH-1056 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for 1-3 year olds. / ___ English $6.43 for 50
___ Spanish$6.83 for 50
___ Chinese$6.83 for 50 ___Armenian$6.83 for 50
Ages 4-8 Years: Growing Up With KP Kids PDF / MH-1041 English
MH-1049 Spanish
MH-1065 Armenian
MH-1057 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for 4-8 year olds. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Ages 9-13 Years: Growing Up With KP Kids PDF / MH-1042 English
MH-1050 Spanish
MH-1066 Armenian
MH-1058 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for 9-13 year olds. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Ages 14-18 Years (Female): Growing Up With KP Kids PDF / MH-1043 English
MH-1051 Spanish
MH-1067 Armenian
MH-1059 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for 14-18 year old females. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Ages 14-18 Years (Male): Growing Up With KP Kids PDF / MH-1044 English
MH-1052 Spanish
MH-1068 Armenian
MH-1060 Chinese / Guides parents in choosing the right portion size of healthy foods and encourage physical activity for 14-18 year old males. / ___ English $6.43 for 50
___ Spanish $6.83 for 50
___ Chinese $6.83 for 50 ___Armenian $6.83 for 50
Encouraging A Healthy Weight for Your Child Tipsheet / 90433 English
90462 Spanish / For parents of overweight/at risk school age children. Promotes healthy eating/ physical activity for the whole family and explains BMI. / ___English $4.95 for 50
___Spanish $4.95 for 50
Eating and Exercising: What Works for You? Tipsheet / 92015 English / Encourages teens to increase healthy foods/physical activity / ___ English $4.95 for 50
Body Image: Learn to Like What you See Tipsheet / 99842 English / Helps teens assess and improve body image. / ___ English $4.95 for 50
Nutrition for Children Tipsheet / MH0806 English
MH0881 Spanish / General nutrition tips for parents to help their infants, toddlers, children eat well, including healthy snacking. / ___English $6.51 for 50
___Spanish $6.62 for 50
Nutrition: Self-Care Tips PD / MH0805 English
MH0876 Spanish / Seven simple guidelines for eating healthy for adults. / __English $6.51 for 50
___Spanish $6.62 for 50