Order Form - Caries Prevention Material
Thank you for your interest in our educational material. They are designed to provide evidence-based mes-
sages about preventing childhood caries, and can be used to introduce key oral health messages to parents
and care-takers, as well as reinforce previous educational messages. We encourage using these in health cen-
ters, well-baby clinics, dental clinics, and with preschool programs, WIC, and Head Start centers.
To order your caries prevention material:
1. Section A: Mailing information— Fill in your contact information.
2. Section B: Magnets & DVDs— Enter the number of Magnets & DVDs you would like in the box next to
each option.
3. Section C: Poster Choices— Enter the quantity of each poster you would like (limit 5) in the box next to
each poster number.
4. Save the completed form and email it to: [email protected].
Section A: Mailing information
Please enter the name and mailing address to send the posters to:
Name______________________________________________ Title ________________________________
Organization ____________________________________________________________________________
Address ________________________________________________________________________________
City __________________________ State ____ Zip ________
Email __________________________________ Phone ________________________________
Section B: Magnets & DVDs
Lift-the-Lip (Similar to Poster #8
Fluoride Prevent Cavities (Similar to Poster #6)
DVD: Healthy Mouths for You and Your Baby
DVD: Boca Sanas para Tí y Tu Bebé (Healthy Mouths for You and Your Baby with Spanish subtitles)
If you have difficulty using this form electronically, you may mail your order form to:
University of Maryland School of Public Health
Herschel S. Horowitz Center for Health Literacy
Oral Health Poster Order
2367 SPH Building #255
College Park, MD 20742
ENGLISH — Posters
SPANISH — Posters
Section C: Poster Choices
1 2 3 4
5 6 7 8
11 12 13 14
15 16 17 18
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