Order Form

Parents

You can receive your program guide and other Newborn Channel materials through your maternity nurse. For more pregnancy and parenting information, be sure to visit iVillage.

Maternity Nurses

Place your order for FREE Newborn Channel materials here! For questions about your order, please call customer service at 866-280-1750.

 

I represent that I am a healthcare professional in a Newborn Channel-subscribing hospital who agrees to distribute these materials, free of charge, to new parents in a healthcare setting. I understand that I have received the materials based upon my previous statement and that any misrepresentation, improper distribution, or resale of the materials is strictly prohibited.

Mailing Address
Salutation:

*First Name:

Middle Initial:

*Last Name:

Suffix (RN, BSN, etc.):

Job Title:

 
*Institution Name:

Department/Suite:

*Street Address or PO Box:

*City/State/Zip:

     
*Telephone Number/Extension:

 
Email:

*State of birth for verification of order:

Shipping Address (if different)
Institution Name:

Department/Suite:

Street Address or PO Box:

City/State/Zip:

     

Order Information

Quantity

5

10

15

20

Other
Large Posters (20" x 30")

Easel-back cards, English (Suggested quantity: one per room)

Easel-back cards, Spanish (Suggested quantity: one per room)

TV stickers (Suggested quantity: one per television, including waiting and triage rooms)

Resources and contact cards

Program guides

50

100

150

200

Special Instructions:

 

* Required Fields

 
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©2008 iVillage Parenting Network. All Rights Reserved.
This Newborn Channel service area is designed for educational purposes only. You should not rely on this information as a substitute for personal medical attention, diagnosis or hands-on treatment. If you are concerned about your health or that of a child, please consult your family's health provider immediately.