Tobacco Prevention and Control Program
Order Form

             

If you have questions call 800.280.5512.

Enter the quantity wanted for each item and the information requested below and press the "Submit" button at the bottom of the page.

Please limit quantities to 250 per item.

 
Brochure         
Brochure           
         
Patient Information palm card (2.75 x 11)         
Mother with Child        Pregnant Woman 
Young Couple    Blue-collar Worker 
Older Couple        Mother with Child (American Indian)     
Male with Child (American Indian)        Spanish Language Female    SpanishFemale 
Spanish Language Male    SpanishMale    Air Force     
Army National Guard         College Student     
         
Wallet Card        
NDQuits Wallet card           
         
Posters        
Many Ways (11x17)      NDQuits Key 
(Each poster comes with 2 tear off pads) 		  
         
Other
Find Your Freedom (2.75 x 11)      Find Your Freedom (8.5 x 11) 
20-Minutes foldover card (3 x 2.5)        SIDS Poster 
Tear Off Pads      Easels      
         

                                     

Date:   

Name:    

Business/Health Agency Name:    

Mailing Address:   

City:      State:   Zip:        

Phone Number:        

Email:    

 
         
 
If you experience trouble submitting the form online, you can call your order in to the North Dakota Division of Chronic Disease at 800.280.5512 or 701.328.2333.