MSV Foundation

Antibiotic Resistance Awareness Materials - Request Form

You will receive the requested materials in 1 to 2 weeks. The items are free of charge to Virginia doctors and caregivers for use with their patients.

Quantity  
Patient Brochure "What you Need to Know About Antibiotics"
Viral Prescription Pad (Adults)/100 tear-off sheets per pad
Viral Prescription Pad (Children)/100 tear-off sheets per pad
"Snort, Sniffle, Sneeze" Waiting Room Poster
We Wash, Do You? (Children - Poster) 11x15
I Washed, Have You? (Adults/Seniors-Poster) 11x15
6 Steps to Hand Washing Poster (11x8.5 - laminated poster)
Wash - Colorful Hands Stickers (18 stickers/sheet)


To process the request, please fill in the following information:

* - denotes a required field
Name:
Specialty:
Address:
City, State, Zip:
Phone:
  *  E-mail:
From: 
Email:  
To: 
Email:  
Subject: 
Message: