Bright Futures Resource Request Question Title * 1. First and Last Name Physical Address (where the resources should be sent, cannot mail to a po box) Question Title * 2. Email Address Question Title * 3. Select your agency (choose all that apply) Local Public Health Head Start Early Head Start Health Tracks Medical Home Other Name of Agency Question Title * 4. Select the following Bright Futures Resources you would like to receive. (Please keep in mind that supplies are limited, so you may not receive all of the materials requested.) Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolscents – Third Edition Bright Futures Tool and Resource Kit (CD) – Third Edition Performing Preventive Services – A Bright Futures Handbook Nutrition Pocket Guide Bright Futures Family Pocket Guide Bright Futures Guidelines Pocket Guide Thank you for your request. Please allow 10 business days for delivery of resources. Once you receive the resources, you can watch the videos and then complete the online evaluation/post-test. Done