NCODH Web Page

Out of State Order Form

This order form is for out-of-state residents only. Please use the North Carolina form for publications to be shipped to residents inside North Carolina. Charges apply for out-of-state orders -- refer to the second column for per-publication charges.

Please fill out all the information below, and enter the number of copies of each publication you would like to receive in the box beside it. When you are finished, hit submit and an order form with a balance (if appropriate) will be displayed so that you can print it out. If you have any questions or problems using the form, please contact Chris Mackey or call 919-966-0865 to place an order over the phone.

Publication (click on the Title to go to a description and on-line version of the publication)	Price	Quantity
Breast Health Care: Easy to Read, Easy to Understand Order quantity limited to 15 Postage fees will be charged: $10 inside USA and $20 international	$0.00
Removing Barriers to Health Care: A Guide for Health Professionals	$3.00
Removing Barriers to Health Clubs and Fitness Facilities: A Guide for Accommodating All Members, Including People with Disabilities and Older Adults	$4.00
Removing Barriers: Planning Meetings That Are Accessible to All Participants	$4.00
Recreation: A Great Way to Be Active	$3.00
Recreación: Una buena manera de ser active	$3.00
Teaching, Responding, & Communicating Quality Physical Education	$0.00
Orchid	$4.00
Orquídea	$4.00
Growing Up with Spina Bifida	$3.00
Creciendo con espina bifida	$3.00
Partners in Health Care: Women with Disabilities and their Health Care Providers	$0.00
Participando en los cuidados de salud	$0.00
Depression and Disability	$4.00
Depresión y Discapacidad	$4.00
North Carolina Plan for Promoting the Health of People with Disabilities 2003-2008	$5.00
Oficina de discapacidad y salud de Carolina del Norte Hoja Informativa	$0.00

We will need the following personal information. Field labels in bold are required.
Name
	(Be sure this is correct so we can contact you in case we have questions.)
Organization
Address
Email
City
	If you live inside of North Carolina, please go to: Form for people living in NC
State	(International customers, please select "Outside United States" as your state)
Country
Zipcode
Phone
Fax
How do you plan to use the product?
Date Materials Needed

** NCODH will make our publications available in alternate formats such as large print, braille, audio, and diskette whenever possible. Please note this may not be possible for all publications.