Publication and Product Order Form Publication Order Form GETTING STARTED (FREE RESOURCES) Understanding Hydrocephalus Guide This informational booklet provides an overview of the diagnosis and treatment of hydrocephalus and normal pressure hydrocephalus (NPH), as well as information about the work of the Hydrocephalus Association. There are separate versions available: one for families of pediatric patients, and another for adults and those with NPH. These booklets are designed for distribution to individuals who are newly diagnosed or new to the Association. A Guide for Adult/NPH Packet Quantity A Guide for Families Packet Quantity Understanding Hydrocephalus Information Card Replacing the HA brochures, this 5.5”x8.5”, two-sided card is perfect to distribute in medical offices and at local events. Info Card Quantity Understanding Normal Pressure Hydrocephalus (NPH) Information Card Replacing the NPH brochures, this 5.5”x8.5”, two-sided card is perfect to distribute in medical offices and at local events. NPH Card Quantity HydroAssist Mobile App Information Card This 5.5”x8.5”, two-sided card is perfect to distribute in medical offices and at local events. HydroAssist Card Quantity Hydrocephalus Association Patient Powered Interactive Engagement Registry (HAPPIER) Card This 5”x7”, two-sided card is perfect to distribute in medical offices and at local events. HAPPIER Card Quantity Support and Education One-Pager This 8.5”x11”, one-pager highlights the programs and services HA offers for people impacted by hydrocephalus. S&E One Pager Quantity Total Quantity PRODUCTS Hydrocephalus Awareness Shunt Pins (10 per box) - English Edition Shunt pins are made out of real shunt tubing! Cost Per Box USD: $30.00 Shunt Pin (English) Total Hydrocephalus Awareness Shunt Pins (10 per box) - Spanish Edition Shunt pins are made out of real shunt tubing! Cost Per Box USD: $30.00 Shunt Pin (Spanish) Total Hydrocephalus Association – Stylus Pens Cost Per Unit USD: $3.00 Pens Total Hydrocephalus Association Brain Stress Balls Cost Per Unit USD: $2.00 Brain Stress Ball Total Total Shipping not included SHIP TO After you order is placed, we will contact you to collect payment information. You will have a chance to review your order and shipping cost before we process any payment. Name * Name First First Last Last Organization Email * Address (No P.O. Boxes) * Address (No P.O. Boxes) Address (No P.O. Boxes) Address (No P.O. Boxes) City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Submit If you are human, leave this field blank. Δ Was this resource helpful? Yes No Submit Cancel Thanks for your feedback!
