F2FHIEC Online Order Form

Family-to-Family Health Information & Education Center

Partner Order Forms

Choose a partner and view materials that are available for you to order:

F2FHIEC Materials Order Form

Person Ordering Materials
Contact Name
Organization
Street Address
City
Zip
Phone
Fax
Email
Special Instructions
Shipping Information
Ship to
Street Address
City
Zip
Materials and Quantities Requested
Quantity	Publication Name
English	Transition Video: Helping Young Adults with Disabilities Reach Their Hopes and Dreams Purpose: Address issues faced by young adults with special needs as they transition to adulthood including career development, education, employment, health care, independent living, and recreation. Discuss the Education Development Plan (EDP), Individualized Education Plan (IEP), Person Centered Plan (PCP), and Transition Plan of Care. Target Audience/Outreach: Youth, Families and Professionals in Michigan Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families receive services.
English Spanish Arabic	Being Prepared for an Emergency Booklet Purpose: Help prepare for a child's or youth’s health care needs in case of an emergency. It includes a fill-in-the-blank form. Target Audience/Outreach: Youth and Families in Michigan Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English Spanish Arabic	Children with Special Needs Fund Brochure Purpose: Explain fund requirements and assistance available. Target Audience/Outreach: Children birth to age 21 with a special health care need. Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English	Children’s Special Health Care Services Insurance Premium Payment Benefit Brochure Purpose: Explain how the program may pay insurance premiums for enrolled families who cannot afford to pay them Target Audience/Outreach: Youth and Families receiving Children Special Health
English	Family Center Magnets Purpose: Provide families with a convenient resource containing the toll-free Family Phone Line Contact Number. Target Audience/Outreach: Children birth to age 21 with a special health care need. Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this.
English	Family Guidance: Transition Planning for Youth Pamphlet Purpose: Provide guidance for transition: independent living, health care skills, health care coverage, education and employment. Target Audience/Outreach: Youth age 14-21 with a special health care need including youth enrolled in Children’s Special Health Care Services. Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English	Family Guide to Michigan’s Children with Special Health Care Services Program Brochure Purpose: Explains how CSHCS works, how to get help and how to get help from others. The Guide provides details community resources, eligibility, applying, coverage, rights and responsibilities, appealing, frequently asked questions, building health partnerships, and more. Target Audience/Outreach: Youth and Families receiving Children Special Health Care Services.
English Spanish Arabic	Family Support Network Brochure Purpose: Explain network services Target Audience/Outreach: Families of children with special health care needs Suggestions for Brochure Location: Pediatricians' offices, daycares, community agencies serving parents, information booths and tables; anywhere parents would see brochure.
English	Family-to-Family Health Information and Education Center Bookmark Purpose: Highlight Center services Target Audience/Outreach: General Public Awareness Suggestions for Brochure Location: Schools, libraries, daycares, information booths and tables.
English	Family-to-Family Health Information and Education Center Brochure Purpose: Highlight Center services Target Audience/Outreach: Youth and Families in Michigan. Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English	Family-to-Family Health Information and Education Center Training Schedule Purpose: Highlight trainings offered for the current year Target Audience/Outreach: Youth, Families and Professionals in Michigan Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see the schedule.
English Spanish Arabic	Free and Low Cost Health Care Coverage Available to Michigan Adults, Children, Pregnant Women and Families Booklet Purpose: Highlight public health insurance programs in Michigan Target Audience/Outreach: General Public Awareness Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English	Frequently Asked Questions About CSHCS Coverage Brochure Purpose: Answer common questions like how to use the eligibility notice and mihealth card, what is covered, bills, medical conditions, adding a provider, changes in family household or medical care, equipment and medical supplies, out-state-care, and other needs about Children Special Health Care Services Target Audience/Outreach: General Public Awareness Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
English	Using Other Health Care Insurance with Children’s Special Health Care Services Brochure Purpose: Explain how health insurance benefits are coordinated for children enrolled in the program Target Audience/Outreach: General Public Awareness Suggestions for Brochure Location: Community agencies, schools, physicians' offices, information booths and tables; anywhere youth and their families can see this brochure.
Office Use Only Materials requested through: Email Phone Mail Fax Date of request: