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Order Materials Form

Home>Order Materials Form

Order Materials Form Katie Von Derau 2018-09-04T13:07:47-08:00

Washington Poison Center prevention and education materials are FREE and available to Washington State residents. Quantities are limited. If you need further help to complete this form, please contact: materials@wapc.org.

Name*
First Last
Address/Billing Address*
Street Address Address Line 2 City ZIP Code
State
Ship to the billing address?*
- Yes
- No
Shipping Address if Different from Above*
Street Address Address Line 2 City ZIP Code
State
Your Washington State County (i.e. Snohomish, Spokane, Clark)*
Phone
Email*
Yuk Pak only*
If you are NOT ordering other materials, check Yes. The Yuk Pak includes: a Mr. Yuk magnet, 2 sheets of Mr. Yuk stickers, and a current Seasonal Health Alert. TO PROCEED TO ORDER OTHER MATERIALS, check the NO box.
- Yes
- No
Name of organization that you are ordering materials for (write NONE if not applicable)*
Are you with a non-profit organization?*
- Yes
- No
To order materials, please choose from one of the following:*
- Personal Home/Family
- Local Health Jurisdiction
- Hospitals and Primary Care Clinics
- Schools (Preschool-High School)
- Community Organizations
YUK PAK
- YUK PAK (one)
The Yuk Pak includes: a Mr. Yuk magnet, 2 sheets of Mr. Yuk stickers, Mr. Yuk First Aid Tips wallet card, and a current Seasonal Health Alert.
PROFESSIONAL/ORGANIZATIONAL USE - Mr. Yuk Stickers [English only](10 stickers per sheet) Quantity
Price: $0.00
PROFESSIONAL/ORGANIZATIONAL USE - Mr. Yuk Stickers [Multi-Lingual](10 stickers per sheet) Quantity
Price: $0.00
message on back in Vietnamese, Russian, Tagalog, Spanish, and Chinese (simplified) Quantities limited to 250 sheets
PROFESSIONAL/ORGANIZATIONAL USE - Mr. Yuk Magnet - 1.75 inch Quantity
Price: $0.00
Quantities limited to 25
PROFESSIONAL/ORGANIZATIONAL USE - Mr. Yuk Magnet - 3 inch Quantity
Price: $0.00
Quantities limited to 25
If you need more than the maximum quantities listed, please describe the event or class, what quantities you would like, and we will contact you at the phone number you provided.

The Washington Poison Center (WAPC) provides immediate, free, and expert treatment advice and assistance on the telephone in case of exposure to poisonous, hazardous, or toxic substances. All calls are confidential.

OUR MISSION: To prevent and reduce harm from poisoning through expertise, collaboration, and education.

Contact Information
155 NE 100th Street
Suite #100
Seattle, WA 98125

Administrative Office: (206) 517-2350

EMERGENCY: (800) 222-1222

TTY users dial 711 for the Washington Relay Service

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