GV Order Form: Gynecologic Cancers

GrapeVine

Material Order Form

Partner Contact Information: *This question is required.

First Name

Last Name

Date of Session

Gynecologic Cancers
Please enter the number of copies you need for this session only. Do not order more than needed for this session.

General Materials

If you are interested in ordering Well Badger Resource Center materials, please use the following link.

	Health Care Screening Results Card (WWHF)
	Health Resources Contact List (WWHF)
	Wisconsin Well Woman Program (WWWP) Information / Eligibility Guidelines
	Helping People Help Themselves to Better Health (WIHA)
	GrapeVine Notecard (WWHF) (Limit 5)

Gynecologic Cancer Unit Materials

	PowerPoint Slides – Gynecologic Cancers – Going Public with “Private” Concerns (06/2023)
	Influences on Chronic Disease
	Wisconsin Well Woman Program Information
	Ovarian Cancer Fact Sheet
	Uterine Cancer Fact Sheet
	Cervical Cancer Fact Sheet
	Vaginal and Vulvar Cancer Fact Sheet
	Family History & Cancer
	HPV Vaccine
	Family Planning Only Services
	SMART Goal-Setting Worksheet
	Participant Incentive Gift – Flashlight

Spanish Gynecological Cancers Unit Materials
(Note: the PowerPoint is not available in Spanish)

	Ovarian Cancer Fact Sheet (Inside Knowledge 2017)
	Uterine Cancer Fact Sheet (Inside Knowledge 2017)
	Cervical Cancer Fact Sheet (Inside Knowledge 2017)
	Vaginal and Vulvar Cancer Fact Sheet (Inside Knowledge 2017)
	HPV Take a Shot at Cancer (ACS 2019)

Forms

	Educational Session Surveys (also includes Check List, Participant Sign-In Sheet(s), Session Report Form and Return Envelope) [Unit Forms]

Do you have any other requests or comments for this order? Please indicate here if you need any COVID kit materials: Signage with GrapeVine’s Face Covering and COVID-19 Symptoms Policies, box of disposable masks or hand sanitizer.