Us TOO International Prostate Cancer Education and Support Network: Survey

If you are an Us TOO Chapter Leader or a Healthcare Provider such as a hospital or a urologist's office and would like to order large quantities of our patient education or awareness material, you can do so here.

How to Order

Simply enter the number of pieces needed next to each item.
Scroll down and fill in your mailing address.
Click the "Submit Order" button below.

*Please note that all shipments will be sent USPS or UPS Ground. If you require your package sooner than ten days from the time of ordering, please call Jackie at 630-795-1002. She can arrange for a quicker delivery at your expense.

All material is available as is and shown and subject to availability.

*

Question - Required - Please tell us the name of your Chapter if applicable:

Newly Diagnosed Patient Resources

Question - Not Required - Resource Kit for Making Prostate Cancer Decisions (MAX 10),

Question - Not Required - Pathways for New Prostate Cancer Patients (MAX 20),

Question - Not Required - What You Need to Know About Your Partner's Prostate Cancer (MAX 100),

Question - Not Required - Signposts Along the Pathway of Prostate Cancer (MAX 20),

Advanced Patient Resources

Question - Not Required - Advanced Disease Kit (MAX 10)

Question - Not Required - In Control: The Facts About Male Urinary Incontinence(MAX 20),

Question - Not Required - The Prostate Cancer Playbook (MAX 50),

Question - Not Required - What Now? Book (MAX 200),

Question - Not Required - Prostate Cancer Patient's Guide to Hormone Therapy (MAX 100),

Question - Not Required - The Prostate Cancer Recovery Guide: Hope, Recovery & Support. Insights to Help You Live Life Restored After Prostate Cancer Surgery

Question - Not Required - What you Need to Know for Better Bone Health Booklet (MAX 100),

Question - Not Required - Prostate Cancer and Incontinence: Coping Strategies and Treatment Options (MAX 10),

Question - Not Required - Clinical Trials For Advanced Prostate Cancer (MAX 10),

Question - Not Required - Bone Health in Focus: 2011 Report About Prostate Cancer's Impact on Bones (MAX 5),

Awareness Material

Question - Not Required - "SEA Blue" Awareness Poster (MAX 10),

Question - Not Required - "SEA Blue" Minority Awareness Poster (MAX 10),

Question - Not Required - Special News for African Americans Poster (MAX 10),

Question - Not Required - About Us TOO International Brochure (MAX 200),

Question - Not Required - Blue Ribbon Sticker (MAX 10),

Question - Not Required - Spanish DVD (MAX 3),

Question - Not Required - Special News About Prostate Cancer For Men at High Risk Brochure (MAX 100),

Question - Not Required - Special News About Prostate Cancer For Men at High Risk (en Espanol) (MAX 100),

Question - Not Required - A Message about Prostate Cancer for American Indian Men, Alaskan Native Men, and People Who Care About Them (MAX 100),

*

Question - Required - Please tell us what date you need this material by (Please allow up to 10 business days for us to ship the material).

Month

Day

Year

Question - Not Required - Comments? Type them here.

Please ship to (please no P.O. boxes, as most of these orders require UPS, which will not deliver to a P.O. box):


	Title:
*	First Name: Required
*	Last Name: Required
	Email:
*	Street 1: Required
	Street 2:
*	City: Required
*	State / Province: Required
*	ZIP / Postal Code: Required
*	Country: Required
*	Phone Number: Required
	Employer:
	Occupation:
	Yes, I would like to receive e-mail from Us TOO International Prostate Cancer Education and Support Network
	Yes, I would like to receive postal mail from Us TOO International Prostate Cancer Education and Support Network

Question - Not Required - For staff use only:

Question - Not Required - Please fill in the following word or phrase:

Change image

Chapter Leaders and Healthcare Providers