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You are Here: Home Page > Sexually Transmitted Diseases > STD Materials Order Form  

STD Materials Order Form

The New York State Health Department Bureau of Sexually Transmitted Disease Control is offering the following materials free of charge in limited quantities to New York State residents and organizations. You may obtain copies by clicking the quantity of each item needed and completing the requestor information. Please allow three to four weeks for delivery.

*Note: If you cannot use this form, print a copy, mark the quantity of each item needed, and fax the order form to (518) 486-5927.

Requestor Information

First Name: Last Name:

Organization:

Address:

City: State: Zip:

Phone Number:

Email address:

STD Materials Order Form

Chlamydia

English (3835)

1 10 50 100 200 400

Spanish (3836)

1 10 50 100 200 400

Gonorrhea

English (3802)

1 10 50 100 200 400

Spanish (3803)

1 10 50 100 200 400

Syphilis

English (3807)

1 10 50 100 200 400

Spanish (3808)

1 10 50 100 200 400

Genital Warts (HPV)

English (3837)

1 10 50 100 200 400

Spanish (3838)

1 10 50 100 200 400

Genital Herpes (HSV)

English (3901)

1 10 50 100 200 400

Spanish (3809)

1 10 50 100 200 400

Trichomoniasis

English (3839)

1 10 50 100 200 400

Spanish (3840)

1 10 50 100 200 400

Bacterial Vaginosis

English (3831)

1 10 50 100 200 400

Spanish (3832)

1 10 50 100 200 400

Pelvic Inflammatory Disease (PID)

English (3804)

1 10 50 100 200 400

Spanish (3810)

1 10 50 100 200 400

Yeast Infection

English (3833)

1 10 50 100 200 400

Spanish (3834)

1 10 50 100 200 400

Diseases that Spread Through Sex

English (3805)

1 10 50 100 200

Spanish (3806)

1 10 50 100 200

STD & HIV Facts (low literacy)

English (9111)

1 10 50 100 200

Spanish (9112)

1 10 50 100 200

What You Need to Know about the Links Between HIV & STDs

English (0247)

1 10 50 100 200

4 STD Palm Card

English (3827)

1 10 50 100 200 400

Spanish (3829)

1 10 50 100 200 400

Syphilis Palm Card

English (3828)

1 10 50 100 200 400

Spanish (3830)

1 10 50 100 200 400

For educational materials on HIV/AIDS, please visit the NYSDOH AIDS Institute's Publications page.