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Partnership for Clear Health Communication

Special Request Form for Large Quantities of Ask Me 3 Materials

Thank you for your interest in a large-scale implementation program of Ask Me 3. This form should be filled out only if you are requesting high quality files to be sent to a profesional printer. In order to fulfill your request for materials, please complete the form below. [Be sure to hit the “Submit” button at the bottom of the form.]

Due to the significant costs that would be associated with printing a small number of items professionally for you we are making available the brochures and posters for a small fee on our patient safety store. <click here> to enter the patient safety store.

Please note that these requests will be reviewed individually and decisions will be made on a case-by-case basis. You will be contacted by a Partnership representative once a decision has been made, so please be sure to check that the contact information you enter is accurate. Thank you.

 

Name:
Organization:
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Phone Number:
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