STD Guideline Cards Order Form

The Clinical Education Initiative (CEI) is excited to offer STI treatment recommendation clinic cards and related materials, free of charge to providers caring for patients in New York State and surrounding states. These are convenient point of care cards reflecting the current CDC STI Treatment recommendations. We also offer lanyards showcasing the CEI Clinic Line, retractable card holders, and copies of the CDC STI Treatment Guidelines 2021 wall chart. Complete this survey to place your order.

Any questions can be directed to Corrie Lese at Corrie_Lese@urmc.rochester.edu.

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* 1. First and Last Name:

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* 2. What organization do you work for:

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* 3. Complete Mailing Address:

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* 4. Email address

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* 5. Phone number:

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* 6. Number of Syphilis cards you are requesting:

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* 7. Number of Gonococcal and Chlamydial/ Nongonococcal Urethritis (NGU), Epididymitis, and Cervicitis cards you are requesting:

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* 8. Number of Pelvic Inflammatory Disease and Bacterial Vaginosis/Mycoplasma genitalium, Trichomoniasis, and Persistent/Recurrent NGU cards you are requesting:

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* 9. Number of Genital Herpes/Genital Warts cards you are requesting:

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* 10. Number of Summary of CDC STI Treatment Guidelines 2021 Wall Charts are you requesting?

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* 11. Number of Lanyards you are requesting.

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* 12. Number of retractable card holders you are requesting.