Brochure & Poster Distribution Order Form

Brochures & Posters are applicable to Wayne County residents

General Information

Required Fields are marked with a red asterisk

Date of Request

mm/dd/yyyy

Requested By

Provider Name

Phone Number

Phone

Brochure & Poster Information

Indicate the number of each requested brochure/poster. DWIHN will accommodate number of requests as much as possible, but there may be limitations in some cases.

ADVANCE DIRECTIVES

AMBASSADOR CARDS

(limit 10 per order)

ANTI STIGMA BROCHURES - COMMUNITY

ANTI STIGMA BROCHURES - MEMBER

ANTI STIGMA BROCHURES - PROFESSIONAL

GRIEVANCE & APPEALS BOOKMARKS

HOW CAN CUSTOMER SERVICE HELP YOU

HOW TO OBTAIN EMERGENCY & AFTER-HOUR BROCHURES

HOW TO OBTAIN ROUTINE MENTAL HEALTH SERVICES

KEVIN’S LAW

KNOW YOUR RIGHTS (SUD)

MEDIATION

MEMBER HANDBOOKS

MEMBERS’ RIGHTS & RESPONSIBILITIES

PROVIDER DIRECTORY

WE CARE CUSTOMER SERVICE POSTER

WE CARE DUE PROCESS POSTER

WELCOME TO DWIHN

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