Make NY the Healthiest State
New York State Department of Health
Order Form
The Make NY the Healthiest State brochure is now ready for order.
Bulk orders cannot be delivered to post office box numbers. Please
provide your complete address, including zip code and phone
number. Feel free to photocopy the order form so you can keep the
original for future use.
Send your order to:
NYS Department of Health Distribution Center
21 Simmons Lane
Menands, NY 12204
or fax to:
518-486-2361
or e-mail to:
[email protected]
TITLE
Make New York the Healthiest State
CODE
NUMBER QUANTITY
8075
Date:
Shipping Label: Please Type or Print Neatly
NYS Department of Health Distribution Center
21 Simmons Lane
Menands, NY 12204
Name:
________________________________________________
Organization:
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Street Address:
________________________________________________
________________________________________________
City/State/Zip:
________________________________________________
Phone Number:
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