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GrapeVine Project Material Order Form (Revised 01/12) Name of Parish Nurse Partner: _______________________________________________ Date Materials Needed: _____________________________________________________ Do not order more than needed for sessions Quantity Pub/Product # WCHP WMCH WWHF 007 WWHF 009 WWHF 012 WWHF 036 WWHF 037 WWHF 038 WWHF 044 WWWP ADA ADA DHHS/HRSA ADA WDA NIH/NIDCR NIH/NIDCR NIH/NIDCR ADA NIH/NIDCR NIH/NIDCR NIH/NIDCR NIH/NIDCR NIH/NIDCR WWHF 045 Women’s Health Info Center Women and Oral Health Unit Publication/Product Title GENERAL MATERIALS Health Care Screening Results Card Wisconsin Maternal and Child Health Hotline fact sheet (01/10) Plastic bags with WI Women’s Health Foundation logo Wisconsin Women’s Health Foundation Brochure GrapeVine Project Flyer Wisconsin Women’s Health Guide, 2011 Report on Women’s in Wisconsin, 2008 Wisconsin Women’s Health Guide, 2008 (Spanish Version) Health Resources Contact List (03/11) Income Guidelines (2011/2012) ORAL HEALTH MATERIALS Taking Care of Your Teeth and Gums (12/08) Healthy Mouth, Healthy Body: Making the Connection (2011) Two Healthy Smiles: Tips to Keep You and Your Baby Healthy (2008) Women & Periodontal Diseases (2009) Sip All Day, Get Decay (2002) TMJ Disorders (03/10) Oral Cancer: Are You at Risk? (07/10) Chemotherapy and Your Mouth (12/10) Quit Smoking Better Health, Better Life, Better You (2009) 3 Good Reasons to See a Dentist BEFORE Cancer Treatment (09/09) Tres buenas razones para ver a un dentista ANTES de comenzar el tratamiento contra el cancer (3 Good Reasons to See a Dentist BEFORE Cancer Treatment - Spanish Version) (11/11) Periodontal (Gum) Disease (07/11) Seal Out Tooth Decay – A Booklet for Parents (07/11) Selle los dientes contra la caries dental (Seal Out Tooth Decay- Spanish Version) (09/10) Women and Oral Health Power Point Slides (01/24/12) Oral Health – Frequently Asked Questions? (11/17/10) ADA Oral Longevity – A Healthy Mouth for Life (2007) Una Boca Sana para Toda la Vida (A Healthy Mouth for Life - Spanish NIH Oral Health and Bone Disease (10/10) ADA Version) (2007) (OVER) Please return this form to Nora Miller at the Wisconsin Women’s Health Foundation either via fax (608-251-4136) or US mail (2503 Todd Drive, Madison, WI 53713-2341). GrapeVine Project Material Order Form (Revised 01/12) Name of Parish Nurse Partner: _______________________________________________ Date Materials Needed: _____________________________________________________ Do not order more than needed for sessions Quantity Pub/Product # Women and Oral Health Unit Publication/Product Title ORAL HEALTH MATERIALS (continued) DHHS/HRSA DHHS/HRSA NIH/NIDCR ADHA NIH/NIDCR NIH/NIDCR NIH/NIDCR ADA Delta Dental and DHS Oral Health and Health in Women: A Two-Way Relationship (2004) Promoting Awareness, Preventing Pain: Facts on Early Childhood Caries (ECC) (2004) Diabetes: Dental Tips Fact Sheet/La diabetes: Consejos sobre la salud oral (English/Spanish Version) (12/10) Want Some Life Savings Advice? Ask Your Dental Hygienist About Oral Signs and Symptoms of Diabetes (06/01/11) PLAQUE – What it is and how to get rid of it (07/99) Finding Low-Cost Dental Care (10/08) Cómo encontrar cuidados dentales a bajo costo (Finding Low-Cost Dental Care – Spanish Version) (05/10) Methamphetamine use and oral health (10/05) Toothbrushes, toothpaste and dental floss NOTE – All materials from NIH/NIDCR are free (including shipping) but there is a limit on most items Due to these limits, all materials from NIH/NIDCR should be ordered directly at https://www.nidcr.nih.gov/OrderPublications/ Please return this form to Nora Miller at the Wisconsin Women’s Health Foundation either via fax (608-251-4136) or US mail (2503 Todd Drive, Madison, WI 53713-2341).
