Printed Guide Request Form

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Printed Guide Request Form

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Email *

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Name *

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Organization *

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How many of each guides would you like?

Limit 3 complimentary copies per publication. For pricing on additional copies contact hcdi@hcdiny.org.

Diabetes Self-Management Guide

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0

1

2

3

Spanish Diabetes Self-Management Guide

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0

1

2

3

"Is Your Diabetes Being Managed?" Brochure

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0

1

2

3

Asthma Consumer Education and Self-Management Booklet

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0

1

2

3

Asthma Self-Management Guide

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0

1

2

3

Obesity Self-Management Guide

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0

1

2

3

Heart Disease Self-Management Guide

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0

1

2

3

Send me a copy of my responses.

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