Blue-colored text is generally a link and will change to green/underlined text.     

 
SCHOOL MATERIALS ORDER FORM
 
LA County - Immunization Program
Contact: Eva, 12502 Van Nuys Bl, #204
    Pacoima, CA  91331
    818 896-6255, Fax 818 890-7840
You'll need to provide:
  School Name, Address,
  Contact Person, Title, Date,
  Phone # & Fax #

  
Call for order form that includes:
CA School Immunization Record Blue Card (E)
Students Will not be admitted ...(E / S)
CA Immunization Hand Book (E)
Your Child needs more shots for kindergarten (E)
Pamphlets: Hepatitus, Chicken Pox, What if...?
Windows for Child Care providers (pink) (E)
    Windows for Immunization
(E) - English, (E / S) - English & Spanish version

  Association Links:  Associations,  Board, Child/Safety, Classes & Workshops, Dues, For Parents,
Government Links, Meetings, Members By Area, Supplies

  caace1 @ gmail.com or susieskids @ gmail.com (delete spaces in email addresses; NOTE: both recipients are linked)
    lacschoolorderform.htm           Modified:   2/1/08 1