TB Alert resource order form

The Truth About TB resources: / Quantity / Sub-total
A5 leaflets: 1-100 copies £0.15 each; 101-1,000 £0.13 each; 1,001+ price on request
General information:TB and The Truth About TB programme
TB, Drugs and Alcohol
TB and HIV in the African Community
TB in the South Asian Community (English/Urdu combined,
Urdu, Tamil, Gujarati) / English/Urdu / Urdu / Tamil / Gujarati
TB in the Somali Community (English, Somali) / English / Somali
A5 desk-side symptoms and referral cards for GP surgeries
Posters: 1-100 £0.20 each; 101-500 £0.15 each; 501+ price on request
A2: Multilingual symptoms (Swahili, Somali, Gujarati, Urdu)
A3: Multilingual symptoms (Tamil, Somali, Gujarati, Urdu)
A3: The sooner the better
A3: Don’t pass it on
A4: The sooner the better
A4: Don’t pass it on
Wallet sized, TB symptoms cards: 1-5,000 £0.05 each; 5,001+ price on request
The Real Story DVD (plays in: Arabic, Bengali, English, French, Gujarati, Polish, Portuguese, Somali, Swahili, Tamil, Tigrinya and Urdu) 1-100 £1.00 each; 101+ price on request
Pens: 1-100 £0.30 each; 101-500 £0.25 each; 501+ price on request
T-shirts: 1-20 £5.00 each; 20+ price on request
Symptoms animation and screensaver (by email) FREE
Total
Patient information leaflets: / Order quantity, per language / Sub-totalquantity
English / Gujarati / Somali / Tamil / Urdu
TB: your questions answered
TB and the BCG
TB and its diagnosis
TB treatment
Your TB drugs
Contact tracing and screening
Latent TB treatment
Multi-drug resistant TB
An important test (TB-HIV)
Total number of leaflets
Leaflet costs (see prices below) / £
Leaflet costs / 10 / 20 / 30 / 40 / 50 / 100 / 250 / 500
£5.00 / £9.50 / £13.50 / £17.00 / £20.00 / £30.00 / £65.00 / £110.00
1,000 / More than 1,000 and other multiples
£180.00 / Prices on request

Patient information digital copies and PDF licences

Language translations are available electronically as digitally printed editions, or in PDF file format, for which you can purchase a 1 or 3 year licence. The licence will entitle you to print off as many copies as you need, within the licensed time period.

Costs / Digital print / 1 year licence / 3 year licence
Single leaflet / n/a / £25 per language / £55 per language
Complete set(all nine titles in a single language) / £5 per language / £165 per language / £ 360 per language
Please tick the title(s) and language(s) required and specify print or licence option(s) required / TB: your questions answered / TB and the BCG / TB and its diagnosis / TB treatment / Your TB drugs / Contact tracing and screening / Latent TB treatment / Multi-drug resistant TB / An important test
(TB-HIV) / Digital print/
1 year licence/
3 year licence / Cost per language
Albanian / £
Bengali / £
Chinese* / £
Farsi / £
French / £
Greek / £
Italian / £
Pashto / £
Polish / £
Portuguese / £
Punjabi / £
Romanian / £
Sorani / £
Spanish / £
Turkish / £
Vietnamese / £
* Simplified Chinese TOTAL COST / £
Please supply the contact details of the person authorised to enter into this licence agreement, and on receipt of this form TB Alert will send them alicence contract.

Your name: Name of clinic: Telephone:

Name of authorising person: Email of authorising person: Telephone:

Total order costs

(Please copy subtotals from previous pages)

The Truth About TB materials
Patient information leaflets
Patient information licences
Total
Delivery details
Name:
Delivery address:
Telephone:
Email:
Invoice details
Organisation:
Purchase order number:
Invoice address:
Email:

Please post this form to TB Alert, 113 Queens Road, Brighton, BN1 3XG, fax it to 01273 371247 or email it to If paying by cheque please make payable to TB Alert. For order queries please call 01273 234029 or email: