CLEARINGHOUSE ORDER FORM

HIV/STD/Hepatitis EDUCATIONAL MATERIALS

The following items are available in quantity, at no charge, from the Ohio Department of Health, HIV/STD Prevention Programs. Materials CANNOT be shipped to a post office box. Check the appropriate column for the amount of materials desired, or use the blank form below to write in the titles and quantities (allowable) requested. All items are subject to availability. Please allow four to six weeks for delivery.

Mail, email, or fax this form to: Ohio Department of Health

HIV Prevention Program Attn: Educational Materials Clearinghouse 1/5/16

P.O. Box 118 Columbus, OH 43216-0118

Telephone: 614-995-5599

FAX: 614-728-0876 Email:

Agency: ______

Name: ______

Address: ______

City: ______, OH Zip: ______Telephone: ______Fax: ______

____ Check if you do not want future updates Email: ______(needed for updates)

ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
HIV/AIDS Literature

H196

/ HIV Facts

R736

Spanish / VIH
English version
[HIV Facts]
47628A / (Pocket Minder)
HIV Prevention and Testing
Your guide to staying safer from HIV

47664A

Spanish / (Pocket Minder)
Prevencíon y prueba del VIH
Su guía para estar más protegido contra el VIH
English version
[HIV Prevention and Testing
Your guide to staying safer from HIV]
81410 / HIV KEEPING TABS on Your Status and Safety
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
81425
Spanish / El VIH Seleccione y lea sobre su estatus y seguridad
English version
[HIV KEEPING TABS on Your Status and Safety]
35441A / HIV Testing - A part of routine health care
35528A
Spanish / La prueba del VIH - Una parte de la atención de rutina de la salud
English version
[HIV Testing - A part of routine health care]
31750D / HIV Testing Get the Facts
30263D
Spanish / La Prueba Del VIH: Conozca Los Hechos
English version
[HIV Testing Get the Facts]
ETR366 / HIV Q & A Rapid Test
812.11 / HIV Testing—Know where you stand / Out / Of / Stock
240.11
Spanish / La prueba del VIH: infórmese sobre su situacion
English version
[HIV Testing—Know where you stand]
44388
English/Spanish
bilingual / You, Your Baby--and HIV/El VIH, su bebé y usted
34406 / A Healthy Pregnancy and HIV Testing
44784 / Women, HIV and AIDS—Facts for Life
44792
Spanish / Las mujeres el VIH y el SIDA: información esencial
English version
[Women, HIV and AIDS—Facts for Life]
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX

0243.11

/ Sisters Talk About HIV: Alma’s Story
(Hispanic/Latina Audiences) / Out / Of / Stock

0244.11

Spanish / Dos hermana hablan del VIH La historia de Alma
English version
[Sisters Talk About HIV: Alma’s Story]
(Hispanic/Latina Audiences)

246.11

English/Spanish
bilingual / Guys and HIV Think About It/Los hombres y el VIH Piénselo

5130

/ Young and Gay Protect Yourself From HIV
5381
Spanish / Joven Y Gay: Protegete Contra El VIH
English version
[Young and Gay Protect Yourself From HIV]

236.11

/ HIV and Men—A Call to men Of Color

237.11

Spanish / Una llamada de advertencia - El VIH y Los Hombres
English version
[HIV and Men—A Call to Men of Color]
76118 / Keep Free From HIV-For Men
(African American Audiences)
241.11 / Brothers Talk About HIV: Manuel’s Story
(Hispanic /Latino Audiences)
242.11
Spanish / Dos hermanos hablan del VIH La historia de Manuel
English version
[Brothers Talk About HIV: Manuel’s Story]
(Hispanic /Latino Audiences)
34280 / For Gay and Bisexual Men
Out & Proud – preventing HIV
30983 / Alcohol, Other Drugs & Sex – Breaking the link to HIV/STDs
34901
Spanish / El Alcohol, Otras Drogas Y El Sexo – Cómo romper el vínculo con el VIH y las ETS
English version
[Alcohol, Other Drugs & Sex – Breaking the link to HIV/STDs]
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
986.11
English/Spanish
bilingual / Drugs and HIV Think About It/Drogas y VIH Pienselo
245.11 / Safer works if you shoot drugs
992.11 / (Pocket Minder)
Protect Yourself If You Shoot Up
Reducing your risk for HIV and hepatitis C infection

5134

/ HIV AND SEX Unsafe Safer Safest

5146

Spanish / EL VIH Y EL SEXO Muy riesgoso Menos riesgoso Poco riesgoso
English version
[HIV and Sex Unsafe Safer Safest]

0205.11

English/Spanish
bilingual / Condoms Think About It/Condones Piénselo
40569 / (Pocket Minder)
Women STDs and Condoms
40552
Spanish / (Pocket Minder)
Las mujeres, las ETS y los condones
English version
[Women STDs and Condoms]
41780 / Condoms– What women need to know / Out / Of / Stock
41913

Spanish

/ Condones: lo que las mujeres deben saber
English version
[Condoms– What women need to know]
ETR159 / Safer Sex Talking with your partner
STD063 / 101 Ways to Make Love Without Doin It
985.11
Spanish / 101 Maneras De Amarnos Sin Tener Sexo
English version
[101 Ways to Make Love Without Doin It]
ETR011 / Living with HIV: Staying Healthy / Out / Of / Stock
ETR015 / Living with HIV: Sex / Out / Of / Stock
33565 / HIV: Positive Choices-Living “Poz”
34279
Spanish / VIH: Opciones Positivas-Viviendo con el positivo
English version
[HIV: Positive Choices-Living “Poz”]
821.11 / Ohio HIV Care Services (brochure)
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
STD Literature

STD153

/ STD Facts

STD165

Spanish / ETS Las enfermedades transmitidas sexualmente
English version
[STD Facts Sexually Transmitted Disease]

47535

/ (Pocket Minder)
STDs your guide for staying STD-free

47606

Spanish / (Pocket Minder)
ETS su guia para mantenerse libre de ETS
English version
[STDs your guide for staying STD-free]
83247C / STDs: Keeping Tabs on Being STD Free
83296C
Spanish / Las ETS: Seleccione y lea sobre cómo evitar contraer ETS
English version
[STDs: Keeping Tabs on Being STD Free]
STD 414 / STD Testing: Sexually Transmitted Disease
STD422
Spanish / ETS Las pruebas: Las enfermedades transmitidas sexualmente
English version
[STD Testing: Sexually Transmitted Disease]
STD185 / Syphilis

R858

Spanish / Sífilis
English version
[Syphilis]

STD186

/ Gonorrhea
ETR116 / Chlamydia
35741 / Facts About STDs
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX

STD428

/ HPV: About the Vaccine

5329

/ HIV, STIs and Oral Sex
5380
Spanish / El VIH, las ETS y el sexo oral
English version
[HIV, STIs and Oral Sex]
STD 5571 / How STIs Affect your Body
STD5607 / Telling Your Partner You Have An STI
Tips for Talking
(Multicultural/LGBT Inclusive)
34189 / HIV/STD Testing For You
(African American Audiences)
HEPATITIS Literature
235 / Hepatitis ABCs
302 / La Hepatitis Tipos ABC
English version
[Hepatitis ABCs]
5608 / Needles HIV and Hepatitis

223.11

/ Stay Free from Hepatitis B / Out / Of / Stock

224.11

Spanish / No sea víctima de la hepatitis B
English version
[Stay Free from Hepatitis B]
45641 / Hepatitis B—Stop the Spread

45658

Spanish / Hepatitis B: detenga la propagacion
English version
[Hepatitis B – Stop the Spread]

30492

/ Hepatitis C Understanding the Risk

30500

Spanish / Hepatitis C Entienda el riesgo
English version
[Hepatitis C Understanding the Risk]
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
222.11
/ Hepatitis C –What you should know / Out / Of / Stock

42986

Spanish / Hepatitis C: lo que usted debe saber
English version
[Hepatitis C—What you should know]
30501 / Hepatitis C and Inmates

30502

Spanish / La hepatitis C y los presos
English version
[Hepatitis C and Inmates] / Out / Of / Stock
YOUTH/YOUNG ADULT Literature

71324

/ Giving Your Child the Facts About HIV and AIDS – From preschool through high school

71332

Spanish / Cómo decir a su hijo(a) la verdad sobre el VIH y el SIDA- desde el preescolar hasta la secundaria
English version
[Giving Your Child the Facts About HIV and AIDS – From preschool through high school]

5128

/ Encouraging Abstinence Ten Tips for Parents

5137

Spanish / Fomentando la abstinencia Diez consejos para los padres
English version
[Encouraging Abstinence Ten Tips for Parents]
76044
English/Spanish
bilingual / Young People Get HIV/
La gente joven contrae el VIH
41350 / HIV and AIDS – Facts for Young People / Out / Of / Stock
45542
Spanish / El VIH y el SIDA: informacion para jovenes
English version
[HIV and AIDS – Facts for Young People]
227.11 / On Postponing Sex (Work book) / Out / Of / Stock
228.11 / Teacher’s Leader’s Guide for On Postponing Sex / Out / Of / Stock
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / XXX / XXX
229.11 / What’s Up With Abstinence (workbook) / Out / Of / Stock
230.11 / Teacher’s /Leader’s Guide for What’s Up with Abstinence
STD516 / STD Facts For Teens
5167 / A Teen’s Guide To STIs
5043 / A Teen’s Guide to HIV and AIDS
5550
Spanish / Guia Para Adolescentes Sobre El VIH Y El SIDA
English version
[A Teen’s Guide to HIV and AIDS]
41772 / Teens Talk about HIV & AIDS / Out / Of / Stock
41905
Spanish / Los adolescents hablan sobre EL VIH Y EL SIDA
English version
[Teens Talk about HIV & AIDS]

5065

/ Sexual Pressure: A Survival Guide For Guys

5149

Spanish / Presión Sexual: Guía De Supervivencia Para Los Hombres Jóvenes
English version
[Sexual Pressure: A survival Guide For Guys]

5116

/ Before You Date An Older Guy

5151

Spanish / Antes De Salir Con Alguien Mayor Que Tu…
English version
[Before You Date An Older Guy]

STD190

/ About HIV and AIDS
(Coloring and Activities book) / Out / Of / Stock

56903

Spanish / Sobre El VIH y El SIDA
English version
[About HIV and AIDS]
(Coloring and Activities book)
POSTERS/AUDIOVISUAL/FORMS
ODH Code / Form Title / Quantity
1 / 3 / 5 / 10 / 15
POSTERS

225.11

/ HIV Facts Poster

226.11

/ STD Facts Poster
263.11 / Ohio Condom Poster -General
264.11 / Ohio Condom Poster - LGBT
Limit 1 / XXX / XXX / XXX / XXX
AUDIOVISUALS
0915.11 / STD Free Living For Teens (A Presentation Kit)
(Binder with Power point on CD & brochures)
EXPANDED HIV TESTING PROGRAM
MATERIALS
ODH Code / Form Title / Quantity
1+ / 25 / 50 / 75 / 100

249.11

/ KNOW YOUR STATUS POSTER (English)

250.11

/ KNOW YOUR STATUS POSTER (Spanish)

259.11

/ Steps Booklet (English)

260.11

/ Steps Booklet (Spanish) / Out / Of / Stock
50 / 100 / 200 / 300 / XXX

257.11

/ Your Status Is Negative Palm Cards (English)

258.11

/ Your Status Is Negative Palm Cards (Spanish
XXX / 100 / 200 / 300 / XXX

251.11

/ HIV Quick Reference Card (English) / Out / Of / Stock

252.11

/ HIV Quick Reference Card (Spanish) / Out / Of / Stock
1+ / 100 / 200 / 300 / XXX

253.11

/ Know Your Status Buttons (English) / Out / Of / Stock

254.11

/ Know Your Status Buttons (Spanish) / Out / Of / Stock

255.11

/ Remind Me Buttons (English) / Out / Of / Stock

256.11

/ Remind Me Buttons (Spanish) / Out / Of / Stock
WRITE-IN
CLEARINGHOUSE ORDER FORM
HIV/STD/Hepatitis EDUCATIONAL MATERIALS
ODH Code / Form Title / Quantity
/ 50 / 100 / 200 / Other

Mail, email, or fax this form to: Ohio Department of Health

HIV Prevention Program Attn: Educational Materials Clearinghouse

P.O. Box 118 Columbus, OH 43216-0118

Telephone: 614-995-5599

FAX: 614-728-0876 Email:

Agency: ______

Name: ______

Address: ______

City: ______, OH Zip: ______Telephone: ______Fax: ______

____ Check if you do not want future updates Email: ______(needed for updates)

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1/5/16