KTPC Print Materials Request Form
If you would like the Kentucky Tobacco Prevention & Cessation Program (KTPC) to mail promotional materials to your organization, please complete the following form.

All orders are subject to availability. If we are unable to fill your order as requested or if there will be delays on our side, we will contact you at the email or phone number you share below. Materials marked with **Last Chance** are available on a first come, first served as they will not be reordered after current stock is depleted.

There is no cost for you to have us mail promotional materials to you. We are able to provide this service through Master Settlement Agreement funds. However, KTPC reserves the right to refuse any materials request. If we will not be able to fill your request, we will notify you in an email.

If you have questions about this process or about your order, please contact KY.TobaccoFree@ky.gov.

Additional materials are also available for you to print yourself (e.g., other fact sheets) or for you to adapt to your needs (e.g., billboards, banners, etc.) at no cost. To access these, please email KY.TobaccoFree@ky.gov with "Digital Materials Request" in the subject line to be connected to the KTCP Communications Specialist.
Sign in to Google to save your progress. Learn more
Contact Person Name *
Organization Name *
Organization Type *
Required
Mailing Address *
Email Address *
Phone Number *
Quit Now Kentucky Materials
Materials to promote 1-800-QUIT-NOW and QuitNowKentucky.org. (Quit Now Kentucky is our quitline for all ages.)
Quit Now Kentucky Referral Card **Temporarily Unavailable Due to 797979 Discontinuation**
3.5'' x 2'' business cards, double-sided. You may print your own updated referral cards (using "Text QUITNOW to 333888") by using the file available here: https://drive.google.com/file/d/1d6E84IZyGg8fZTsVx4e7xA5MZxSaykvD/view?usp=sharing
Captionless Image
Clear selection
Quitters Always Win Referral Card
3.5'' x 2'' business cards, double-sided. You may print your own referral cards (using "Text QUITNOW to 333888") by using the file available here: https://drive.google.com/file/d/137Y0SaeHZ_yGsP5mDj6eor1foxXmhdom/view?usp=sharing
Captionless Image
Clear selection
Kick Butts Referral Card
3.5'' x 2'' business cards, double-sided. You may print your own referral cards (using "Text QUITNOW to 333888") by using the file available here: https://drive.google.com/file/d/1EeK2-bfZOb6MAwbh5J-rEUTDBPSBE-_i/view?usp=sharing
Captionless Image
Clear selection
Quitting for Two (Pregnancy) Referral Card
3.5'' x 2'' business cards, double-sided. You may print your own referral cards (using "Text QUITNOW to 333888") by using the file available here: https://drive.google.com/file/d/1oE89PDPDj8KU0na5nnVNzvC6pTw-WhhY/view?usp=sharing
Captionless Image
Clear selection
Quit Now Kentucky Tri-fold Brochure
3.68'' x 8.5'' tri-fold brochure on glossy paper
Captionless Image
Clear selection
Health Effects of Tobacco Use + What You Need to Know About Quitting  **Last Chance**
8.5'' x 11'' double-sided, printed on semi-glossy paper.
Captionless Image
Clear selection
Quit Now Kentucky Poster
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
Quit, Quit Again Poster **Requires stickers to update**
11'' x 17'' poster on card stock, single-sided. This poster must be updated with stickers to replace the outdated texting information. This poster is only available in multiples of 30, because that is how many stickers are on a sheet. Small text reads: "Quitting tobacco isn't easy, but you don't have to do it alone. Quit Now Kentucky is with you every step of the way with the advice, support, and tools you need to quit for good Plus, it's free -- so get started today."
Captionless Image
Clear selection
Quitters Always Win (Bikes) Poster **Requires stickers to update**
11'' x 17'' poster on card stock, single-sided. This poster must be updated with stickers to replace the outdated texting information. This poster is only available in multiples of 30, because that is how many stickers are on a sheet. Small text reads: "Quitting tobacco isn't easy, but you don't have to do it alone. Quit Now Kentucky is with you every step of the way with the advice, support, and tools you need to quit for good Plus, it's free -- so get started today."
Captionless Image
Clear selection
Quitters Always Win Magnet **Requires stickers to update**
3.5'' x 2'' (business card-sized) flexible magnet. This magnet must be updated with stickers to replace the outdated texting information. This magnet is only available in multiples of 48, because that is how many stickers are on a sheet.
Captionless Image
Clear selection
Kick Butts Magnet **Requires stickers to update**
3.5'' x 2'' (business card-sized) flexible magnet. This magnet must be updated with stickers to replace the outdated texting information. This magnet is only available in multiples of 48, because that is how many stickers are on a sheet.
Captionless Image
Clear selection
Quit Now Kentucky Sticky Notes
4'' x 3'' sticky notes
Captionless Image
Clear selection
Co-branded Quit Now Kentucky and My Life, My Quit Materials
Quit Now Kentucky AND My Life, My Quit "Rx Pads" **Out of Stock**
5.25'' x 4.25'' mock prescription pad with tear-off sheets printed with Quit Now Kentucky promotion on one side and My Life, My Quit promotion on the other side. These are not sticky notes.
Captionless Image
Clear selection
My Life, My Quit Materials
Materials to promote MyLifeMyQuit.com or texting "START MY QUIT" to 36072. (My Life, My Quit is our quitline for ages 17 and under.)
MLMQ Quit Vaping Referral Card
3.5'' x 2'' business cards, double-sided
Captionless Image
Clear selection
Vaping is Still Tobacco Poster **Out of Stock**
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
Cut Out Vaping Poster  **Out of Stock**
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
Vaping Wasn't Just A Trend Poster
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
Vaping Clouded My Future Poster
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
I Broke Up With My Vape Poster
11'' x 17'' poster on card stock, single-sided
Captionless Image
Clear selection
Other Materials
The 5 Rs (Audience: Health Care Providers)
Captionless Image
Clear selection
The 5 As (Audience: Health Care Providers)
Captionless Image
Clear selection
Tailored Tobacco Treatment (Audience: Health Care Providers)
8.5'' x 11'' double-sided, printed on cardstock. Created by the University of Kentucky College of Nursing. Also available at: https://www.uky.edu/bhwell/health-care-providers-0
Captionless Image
Clear selection
Types of NRT (Audience: Public) **NEW**
8.5'' x 11'' single-sided. Not yet available for ordering, but can be downloaded and printed from: chfs.ky.gov/agencies/dph/dpqi/cdpb/hpdocs/NRTflyer.pdf 
Captionless Image
Clear selection
Medicaid & MCO Tobacco Cessation Benefits (Audience: Health Care Providers)
8.5'' x 11'' double-sided, printed on cardstock. Also available at: https://chfs.ky.gov/agencies/dph/dpqi/cdpb/hpdocs/MedicaidandMCOTobaccoCessationBenefits.pdf
Captionless Image
Clear selection
Questions (Optional)
Please reference the file name wherever relevant.
Comments (Optional)
Consider sharing ideas of other print materials that would be helpful to you in the future, information about whether you are requesting these for a specific event or on behalf of a local partner, etc. Please reference the file name wherever relevant.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy