Forms Order

Item	Quantity	Item	Quantity
Materials
After the Shots....What to do if your child has discomfort		Lifetime Immunization Record SFN 13895
NDDoH Schedule using Pentacel		Be Wise - Immunize! Children's Activity Book
NDDoH Schedule using Pediarix		Certificate of Immunization SFN 16038
Recommended Childhood Immunization Schedule (CDC)		Growth Chart
Screening Questionnaire for Child and Teen Immunizations		Vaccine Administration Record (2 Part) SFN 18385
Vaccine Adverse Events Reporting Form (VAERS)		It's their turn fact sheet
VFC Stickers (3/4" round, sheet of 23)		ND Teen HPV Brochure
Pneumococcal Pocket Guide		Zoster Pocket Guide
HPV Poster - Adolescent Boy		HPV Poster - Adolescent Girl
Ready Wrigley Influenza Coloring Book		Top Ten List for HPV #VaxSuccess
Talking to Parents about HPV Vaccine		Take Three Actions to Fight the Flu Brochure
Influenza Vaccine - Older Individual (8x14)		Influenza Vaccine - Older Individual (11x17)
Influenza Vaccine - Pregnant Women (8x14)		Influenza Vaccine - Pregnant Women (11x17)
Influenza Vaccine - Young Adult (8x14)		Influenza Vaccine - Young Adult (11x17)
Influenza Vaccine - Kids (8x14)		Influenza Vaccine - Kids (11x17)

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