Prevention. Promotion. Protection.

Order Form

NOTE: Fields marked with an asterisk (*) are required.

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Provider *

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E-Mail Address

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Comments/Special Instructions

 

Select the publications or forms you want to order by telling us how many you need of each of the following:

Brochures

  • What you need to know about Breast Cancer
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  • Why You Need a Pap Test
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  • Your Role in Protecting Your Breast Health
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  • Your Role After an Abnormal Pap
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  • Cone Biopsy
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  • Cervical Cryotherapy
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  • Understanding Cervical Changes
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  • Fibrocystic Breasts
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  • Breast Biopsy
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  • Understanding Breast Changes
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  • Understanding Breast Biopsy
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  • Tips for a Quality Mammogram
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  • Menopause Facts
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  • Colposcopy
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Gift Cards

  • Gift Card - Black
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  • Gift Card - Generic
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  • Gift Card - Spanish Translation
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  • Gift Card Asian
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Forms

  • BCHC Annual Enrollment Form
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  • BCHC Annual Enrollment Form (Spanish)
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  • BCHC Annual Screening & Data Collection Form,
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  • BCHC Breast Cancer Diagnostic Evaluation & Data Collection Form
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  • BCHC Cervical Cancer Diagnostic Evaluation & Data Collection Form
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Posters

Primary text reads: “I made time to call..I made an appointment and got screened. Get a women’s health exam. Do it for yourself, do it for your loved ones.”

  • Anchorage Market

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  • Barrow AC

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  • Barrow Home

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  • Barrow Subsistence

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  • Basketball

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  • Bethel

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  • Bingo

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  • Dillingham Berry

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  • Fairbanks Waitress

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  • Hair

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  • Hotel

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  • Kodiak Berry

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  • Kodiak Cannery

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  • Kotzebue Basket

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  • Kotzebue Fish Camp Tent

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  • Mammobile

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  • McGrath Hunters

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  • McGrath Moose

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  • Palmer Hairdresser

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  • Samoan

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  • Sandpoint Grandma

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  • Sitka Button Blanket

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  • Theater

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  • Tourist Shop

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