Immunization Resource Order Form Immunization Resource Order Form Name Email Practice Address City ZIP What resources would you like? Check all that apply. Parental Refusal Brochures - Childhood Vaccines (20 of each) DTaP Reminder Pre-Posted Postcards (20) Fast VAX Facts Mobile App Postcards (20) HPV Reminder Pre-Posted Postcards (20) Adolescent Vaccines Pre-Posted Postcards (20) DTAP Drop-Off Toolkit HPV Brochures (100) Additional Notes: Submit If you are human, leave this field blank.
