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Tick Toolkit Request Form
Thank you for your interest in teaching your students about tick safety. Please complete this form to request materials. If you have any questions or need support, please email
ZIVDU@health.nyc.gov
.
*
First Name
(Required.)
*
Last Name
(Required.)
*
School/Organization
(Required.)
*
School or Organization Email
(Required.)
Preferred Email
*
How many students will you be teaching?
(Required.)
What grade(s) do you teach?
3rd grade
4th grade
5th grade
Other (please specify)
Which Tick Toolkit components would you like us to send? Note that the lesson slides, Letter to Parents, and supplemental activity are only available digitally.
Send all materials listed below
Lesson plan
Tick Bagel handouts
Tick Check Harry handouts
Tick Check Harry stuffed dogs and fake ticks (NEEDED FOR ACTIVITY)
All About Ticks children's workbooks
Quantity of All About Ticks children's workbooks in English:
Quantity of All About Ticks children's workbooks in Spanish:
*
Mailing Address (include borough and ZIP code)
(Required.)
Do you plan to use this lesson to fulfill any required learning objectives or standards?
Science
Health education
None
Other
How did you hear about the Tick Toolkit?
NYC Department of Health outreach/presentation
Colleagues
Social media
Online search
Friends/Family
Other (please specify)
Are you interested in being notified when other educational materials are developed by the Health Department?
Yes
No
Are there any other health topics you would like to see materials developed for?
Do you have any questions or comments?
