Order Form For Heroin And Prescription Medication Misuse Fact Sheets

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Howard A. Zucker, M.D., J.D.
Arlene González-Sánchez
Acting Commissioner
Commissioner
ORDER FORM FOR HEROIN AND PRESCRIPTION MEDICATION MISUSE FACT SHEETS
The New York State Department of Health (DOH) and
Materials sent to addresses within New York State are
the New York State Office of Alcoholism & Substance
provided free of charge. Orders outside of New York
Abuse Services (OASAS) have developed educational
State will be charged a fee for shipping and handling.
publications on heroin and prescription opioids. These
Bulk orders cannot be shipped to Post Office Boxes.
materials are available free of charge to NYS residents and
To place an order, please complete the attached form
organizations. The fact sheets are designed for parents,
and send your request to:
educators, health care professionals and others to raise
PUBLICATIONS
awareness and provide important information about the
NYS Department of Health Distribution Center
dangers of opioids and heroin.
21 Simmons Lane
Menands, NY 12204
Fax: (518) 465-0432
TITLE
LANGUAGE
PUBLICATION #
CIRCLE QUANTITY
Is your Medicine Cabinet Safe?
English
1004
1
10
25
50
100
200
Spanish
1005
1
10
25
50
100
200
Russian
12001
1
10
25
50
100
200
Important Information for Parents
English
1037
1
10
25
50
100
200
Spanish
1038
1
10
25
50
100
200
Russian
12002
1
10
25
50
100
200
Prescription Safety
English
1047
1
10
25
50
100
200
Spanish
1048
1
10
25
50
100
200
Russian
12003
1
10
25
50
100
200
Facts on Heroin and Prescription Opioids
English
1067
1
10
25
50
100
200
Spanish
1068
1
10
25
50
100
200
Russian
12004
1
10
25
50
100
200
Students Should Know The Facts
English
1072
1
10
25
50
100
200
Spanish
1073
1
10
25
50
100
200
1
10
25
50
100
200
Russian
12005
Medicine Cabinet Inventory Card
English
1022
1
10
25
50
100
200
Spanish
12006
1
10
25
50
100
200
Russian
12007
1
10
25
50
100
200
Combat Heroin Poster
English
12000
1
10
25
50
/
/
DATE
NAME
EMAIL ADDRESS
ORGANIZATION
STREET ADDRESS
CITY, STATE, ZIP CODE
(
)
TELEPHONE NUMBER
(
)
FAX NUMBER

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