KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

KDPCP

Two Pocket Folder P P

KDPCP

Plastic Bags P P P P

KDPCP

Note Pad P P

KDN

Plastic Bags P P P

KDN Note

Pad P P

KDPCP Brochure P P P

Kentucky Diabetes Prevention and Control Program Page 1

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

Kentucky Diabetes Resource

Directory Post Card P P P P

CDC Snapshot of Predibetes

in the United States

Infographics flyer P P

KDPCP The

Power of Prevention

Brochure P P

NIH

Prediabetes What YouNeed

to Know Flyer P P P P

NDEP Choose More Than 50

Ways to Prevent Type 2

Diabetes P P P P

CDC Prediabetes Screening

Form P P P

Kentucky Diabetes Prevention and Control Program Page 2

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

CDC Diabetes Physical

Activity Flyer P P P

CDC Diabetes Prevention

Program Flyer P P

KDPCP Get Tested for

Prediabetes Magnet P

CDC Snapshot of Diabetes

in the United States

Diabetes Infographics P P P

NDEP Know

Your Blood Sugar Numbers P P

CDC/ AMA

Preventing Type 2 Diabetes P

Kentucky Diabetes Prevention and Control Program Page 3

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

2014 KDPCP Diabetes Basic

Booklet-English P

KDPCP Diabetes Basic

Booklet- Spanish P

2014 KDPCP Nutrition

Basics Booklet-English P

KDPCP Nutrition Basics

Booklet-Spanish P

NDEP 4 Steps to Control

Your Diabetes for Life

Booklet P

Krames

Living Well with Diabetes

Brochure P

Kentucky Diabetes Prevention and Control Program Page 4

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

Krames Living Well

with Diabetes Work Book P

KDPCP Being

Prepared for Disaster When

You Have Diabetes

Brochure P

NDEP

Diabetes and Your Heart

Flyer P

KDPCP

If You Have Diabetes, Get

Checked

Magnet P

KDN

I Have Diabetes Folded

Wallet Card P P

KDN

My Diabetes Care Record P

Kentucky Diabetes Prevention and Control Program Page 5

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

KDPCP Have

Diabetes? A Flu Shot Could

Save Your Life!

Brochure P

KDPCP

Have Diabetes? A Flu Shot

Could Save Your Life!

PlastiC Bags P P

KDPCP Have

Diabetes? A Flu Shot Could

Save Your Life!

Poster P

KDN If

You Have Diabetes Protrect

Your Eye Sight

Poster P

KDN If

You Have Diabetes Protrect

Your Eye Sight

Brochure P P

Krames

Gestational Diabetes

Booklet P

Kentucky Diabetes Prevention and Control Program Page 6

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

CDC/ NDEP I Can

Control My Diabetes by

Working with My Health

Care Team

Flyer P P

NDEP Guiding Principles for

the Care of People with or

at Risk for Diabetes P

CDC

National Diabetes

Prevention Program Flyer P

NDEP Working

Together to Manage

Diabetes

Book P

NDEP Tips for

Kids With Type 2 Diabetes

Stay at Healthy Weight

Booklet P

NDEP Tips fo

Kids With Type 2 Diabetes

Eat Healthy Foods

Booklet P

Kentucky Diabetes Prevention and Control Program Page 7

KDPCP Pamphlets in the Phamplet Library as of 6-9-16

Publicatio

n In

The Pam

phlet

Libra

ry

Descrip

tion

Provid

ers

Patients

Public Event,

Health Fair

Media

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0ahUKEwjyz7em3rbNAhWJrD4KH

VXVAp4QFggfMAA&url=http%3A%2F%2Fchfs.ky.gov%2FNR%2Frdonlyres%2F4A50BA58-FB74-4601-BD01-

2992098B95C1%2F0%2FCHFS1210PamphletLibraryPublicationRequestFormR012011.xls&usg=AFQjCNH8ZYaPa6

0mlRTIA0aJXThJcOhe-Q&sig2=jGFw-ldM1E_Lty_d_EZRlg

The link below will take you directly to the online verfsion of the pamphlet library ordering form.

City:

ZIP:

Extension:

Quantity

Requested:

Quantity

Shipped to

Requestor:

Supply NOT

available

for full

shipment: (see note

below)

Please call

Pamphlet

Library to

Discuss Order

Initials of

Staff

Processing

Order:

R

,

NOTE:

Date Shipped:

If a large volume of pamphlets are ordered and supply is not available; the requestor will be sent up to five (5) and the requestor

will need to submit another order at a later date, if the pamphlet is needed.

NOTE: Only this Publication Request

form may be used when ordering Date of Request:

Business Phone: (502) 227-

9529

( )Phone Number:

Title of Pamphlet:

For Pamphlet Library Staff to complete:

(Requestor do NOT write in spaces below)

Purpose for

Pamphlet Library Health Department, Organization, Agency, School:

State: (2-characters)

PUBLICATION REQUEST

Physical Street Address: (PO Box address is not accepted)Frankfort, KY 40601-8412

COMMONWEALTH OF KENTUCKYCABINET FOR HEALTH AND FAMILY SERVICES

DEPARTMENT FOR PUBLIC HEALTH

To be completed by Requestor:

Mail or Fax to: Person Ordering Pamphlet Material: (Full Name)

To ensure the order is correctly process AND to avoid any delays, it is required that all information requested on this Publication

Request form be complete and accurate. Please check information before submitting order.

Fax Number: (502) 227-7191

(NO Phone Requests Accepted)

Frankfort Habilitation

3755 Lawrenceburg Road

A copy of this request form will be returned to requestor to confirm correct shipment.

CHFS-1210

(R. 01/2011)

PUBLICATION REQUEST (CHFS-1210)

PROCEDURAL INSTRUCTIONS

The Publication Request form or CHFS-1210 is to be

used when submitting an order to the Publication Library

located at Frankfort Habilitation, 3755 Lawrenceburg

Road, Frankfort, Kentucky 40601-8412. Pamphlet orders

are only accepted by mail or by faxing the Pamphlet

Library at (502) 227-7191. Telephone requests are not

accepted.

Following is the procedures for submitting an order

request to obtain pamphlet material as outlined on

the CHFS-1210, Publication Request form:

Date of Request: Requestor is to enter the date the

Publication Request form is completed.

Person Ordering Pamphlet Material: Requestor must

enter full name on request form. This will ensure the

Pamphlet Library staff send requested material to correct

person or has a name to use if telephone communication

is necessary.

Health Department, Organization, Agency, School:

Requestor must enter the full name (no acronyms or

abbreviations) of the health department, organization,

agency or school that is requesting the pamphlet material.

Physical Street Address: Request must enter the

complete physical address of the health department,

organization, agency or school as post office boxes are

not accepted.

City: Enter the city associated with the physical street

address. No abbreviations.

State: Enter the two-character state abbreviation

associated with the physical street address.

ZIP: Enter the zip code associated with the physical

street address. If known, please also include the extra 4-

digits.

Phone Number: Including area code, enter the

requestor’s telephone number.

Extension: Enter the telephone extension of the

requestor, if applicable.

Purpose for Request: Requestor should enter the

reason or purpose for submitting request.

Kentucky Diabetes Prevention and Control Program Page 8