New York State Department of Health OPIOID OVERDOSE EDUCATIONAL MATERIALS ORDER FORM Instructions for ordering bulk materials for New York State residents: 
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Please circle only one (1) quantity per publication. Complete the address label on the last page. Be sure to print clearly. ALL orders must include a street mailing address. Bulk order cannot be delivered to Post Office boxes. You can: 
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Fax orders to 518‐465‐0432. Mail orders to: New York State Department of Health Distribution Center, 21 Simmons Lane, Albany, NY 12204; or Email orders to: [email protected]. Title Language See An Overdose? Call 911 Immediately! This palm card explains how to recognize an opioid overdose and what life‐saving steps to take when you witness one. It highlights New York State’s “911 Good Samaritan” law, which protects people from prosecution for drug or alcohol possession if they seek help for an overdose (palm card). 12/12. See An Overdose? Call 911 Immediately! Poster version contains all of the information described in the palm card above (poster). 12/12. Stop Prescription Pain Medication Misuse. This palm card warns about the dangers of misusing prescription pain medications. It encourages readers to keep medications in a place at home where teens and other cannot access them (palm card). 3/12. English Code # 0226 Quantity (circle one) 25 50 100 Spanish 0227 25 50 100 English 0230 10 25 50 Spanish 0231 10 25 50 English 0266 25 50 100 Spanish 0267 25 50 100 Address Label (please print or type) Name Organization (if applicable) Street Address City Telephone State Zip Code E‐mail Delivery: 
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1/2013 Please allow three (3) to four (4) weeks for delivery. Order may not be picked up from the Distribution Center in Albany. Bulk orders cannot be delivered to Post Office boxes. Be sure to include a street address on the mailing label below.