Placing your order is easy! Simply fill out the order form below. To upload copy, logos, other images, mail lists or any other documents associated with this order please use the "Upload A File" feature. Customer Information Healthcare Organization * First Name * Last Name * Email * Phone * Address (No P.O. Boxes, please) * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Shipping Information (if different from above) Company Name Contact Person Street Address City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Project Specifications Product Ordering Key AR Annual Report BA Banner BB Billboard BR Brochure DML Direct Mail Letter DU Duratrans EP Electronic Publications EM Email ENV Envelope FD Folder IK Info/Welcome Kit JPC Jumbo Postcard 2PJPC 2-Panel Jumbo Postcard PC 4"x6" Postcard LOGO Logo/Branding MP Magazine/Publication NPAD Newspaper/Magazine Ad PO Poster RC Recipe Card RK Rack Card TT Table Tent WG Web Graphic WC Window Cling Product (see key)Design # (or custom)Dimensions (if applicable)QuantityDue Date One - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Two - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Three - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Four - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Five - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Six - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Seven - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Eight - None -ARBABBBRDMLDUEPEMENVFDIKJPC2PJPCPCLOGOMPNPADPORCRKTTWGWC # Copywriting Options I will provide copy I will need copywriting assistance (free service) I would like to use sample copy or use design as is Full Service Option No, I do not want image.works to mail my marketing piece Yes, I would like image.works to address and mail my marketing piece Presorted First Class Presorted Standard (bulk mail) We can mail your marketing pieces for you using our presorted first class or standard mail permit. Simply upload your mailing list to our FTP site and we will inkjet, bar-code, zip+four and mail them. Postage will be billed prior to mailing. If you wish to use your own permit number to mail your marketing pieces, please provide the following information: Presorted First Class # or Presorted Standard # (bulk Mail) City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Mailing List Options I will provide my own list I would like image.works to purchase a list for me (a rep will contact you) I would like the following performed on my list Dedupe Merge Householding (one mail piece per address) Other I would like the following performed on my list Other Additional Instructions Project Cancellation If we have provided at least one proof for a project and it is subsequently cancelled before completion, you will be charged for design time. I Accept I Decline Please check the boxes next to the numbers of the disclosures you would like to use, then click the button below Insert Selection Leave this field blank