Order Form - The Royal Children`s Hospital

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Diabetes Flip Chart
This is a comphrensive eduation tool that can be used for all patients with diabetes
either in an individual or group setting.
This is a colourfull and professionally produced flip chart designed by Dr Heather Gilbertson and
trialled at RCH and can be used as the basis of education sessions.
It incorporates healthy eating for diabetes and information on GI.
Order Form
No. of Items
Item
Description
Diabetes flip
chart
Flip chart plus
postage &
handing
$ Per Item
$60.00
$70.00
Total
Cheques
Please make cheques
payable to:
Royal Children’s Hospital
$ Total
$
Credit Card Payment
Card Type:
Bankcard
VISA Card
Mastercard
Card No: - - - - / - - - - / - - - - / - - - Address to:
Nutrition & Food Services
Department
Royal Children’s Hospital
50 Flemington Road
Parkville VIC 3052
Please provide your
contact details and
delivery address
Expiry Date: /
/
Cardholders Name: ______________________________
Signature:______________________________________
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