Access Macquarie Ltd ABN 59 003 849 198 CENTRE FOR EMOTIONAL HEALTH RESOURCE ORDER FORM Full Name ______________________________________________________________________________ Organization ____________________________________________________________________________ ABN___________________________________________________________________________________ Do you require an invoice? Yes No Postal Address __________________________________________________________________________ Email address ___________________________________________________________________________ Phone (please include Country and Area code) ________________________________________________ Please note: we cannot dispatch items until full payment is received. Fax (please include Country and Area code) ___________________________________________________ *PRICES LISTED INCLUDE GST – IF YOU ARE ORDERING FROM OUTSIDE OF AUSTRALIA, ASK US FOR AN INTERNATIONAL ORDER FORM PRICE QUANTITY TOTAL ITEM BOOKS COST ANXB1 Overcoming Shyness and Social Phobia: A step-by-step guide $23.95 ANXB2 Mastering Stress: A Lifestyle Approach $32.95 ANXB3 Panic Surfing – Early intervention $34.95 ANXB4 Helping your anxious child: A step-by-step guide for parents $34.95 ANXB4a Helping Your Anxious Child: Companion Child Workbook $15.00 ANXB5 Treating Anxious Children and Adolescents $99.95 PRICE QUANTITY TOTAL ITEM PROGRAM KITS COST ANXK1 Cool Kids Anxiety Program Kit $65 ANXK1s Cool Kids Anxiety Program Kit, Spanish $65 ANXK1c Cool Kids Anxiety Program Kit, Chinese $65 ANXK1t Cool Kids Anxiety Program Kit, Turkish $65 ANXK2 Cool Kids Anxiety Program Kit - School Version $65 ANXK3 Cool Kids Anxiety Program Parent and Child Workbook Set $35 ANXK3x Cool Kids Anxiety Program Parent and Child Workbook COOL KIDS $315 Set of Ten, English ANXK3xs Cool Kids Anxiety Program Parent and Child Workbook $315 Set of Ten, Spanish ANXK3xc Cool Kids Anxiety Program Parent and Child Workbook $315 Set of Ten, Chinese ANXK3xt Cool Kids Anxiety Program Parent and Child Workbook $315 Set of Ten, Turkish $50 COOL LITTLE ANXK7 Cool Little Kids Program Kit KIDS ANXK7x Cool Little Kids Parent Workbook Set of Ten $160 ANXK15 Cool Kids ASD Anxiety Program Kit $65 ANXK16 Cool Kids ASD Anxiety Program Parent and Child Workbook COOL KIDS $35 Set ASD ANXK16x Cool Kids ASD Anxiety Program Parent and Child Workbooks $315 Set of Ten ANXK4 Cool Kids Adolescent Anxiety Program Kit $65 ANXK5 Cool Kids Adolescent Anxiety Program Kit - School Version $65 COOL KIDS ANXK6 Cool Kids Adolescent Anxiety Program Parent and Adolescent ADOLESCENT $35 Workbook Set (CHILLED) ANXK6x Cool Kids Adolescent Anxiety Program Parent and Adolescent $315 Workbook Set of Ten ANXK17 Study Without Stress Program Kit $50 STUDY WITHOUT ANXK17x Study Without Stress Program Adolescent Workbook $160 STRESS Set of Ten ANXK8 Cool Kids Adolescent Anxiety and Depression Program Kit $75 COOL KIDS ADOLESCENT ANXK10 Cool Kids Adolescent Anxiety and Depression Program Parent $45 ANXIETY and Adolescent Workbook Set AND ANXK10x Cool Kids Adolescent Anxiety and Depression Program $405 DEPRESSION Parent and Adolescent Workbook - Set of Ten OUTREACH ANXK11 Cool Kids Anxiety Child Anxiety Outreach Program Kit $75 INDIVIDUAL MANUALS COOL KIDS & ADOLESCENT (CHILLED) THERAPIST MANUALS (Manual covers both age groups) ANX1T Cool Kids & Adolescent Therapist Manual $40 ANX1Ts Cool Kids & Adolescent Therapist Manual, Spanish $40 ANX1Tc Cool Kids & Adolescent Therapist Manual, Chinese $40 ANX1Tt Cool Kids & Adolescent Therapist Manual, Turkish $40 ANX2 Cool Kids & Adolescent Anxiety Therapist Manual - School Version $40 COOL LITTLE KIDS ANX7P Cool Little Kids Parent Workbook $20 ANX7T Cool Little Kids Therapist Manual $40 ANX15T Cool Kids ASD Therapist Manual $40 ANX17A Study Without Stress Adolescent Workbook $20 ANX17T Study Without Stress Therapist Manual $40 ANX8T Cool Kids Adolescent Anxiety and Depression Therapist Manual $40 ANX11T Cool Kids Child Anxiety Management Outreach Program Therapist Manual $40 COOL KIDS ASD STUDY WITHOUT STRESS COOL KIDS ADOLESCENT ANXIETY AND DEPRESSION OUTREACH SUB TOTAL POSTAGE COST GRAND TOTAL $ $ $ POSTAGE Postage fees will be calculated according to Australia Post regular post prices. Please note that regular post does not enable item tracking or signature-on-delivery. Please call us on 02) 9850 8711 if you would like a quotation or if you would prefer to use an alternative delivery method. AUTHORITY FOR PAYMENT BY CREDIT CARD Client’s Name: __________________________________________ {please print} I authorise payment of $A _____________ + postage on my: MasterCard Visa {please tick} Cardholder’s Name: ____________________________________ {please print} Card No: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiry Date: _________ Signature: ____________________________ Date: _________________________ RETURNING YOUR COMPLETED ORDER FORM AND PAYMENT SLIP: Email: ehc.admin@mq.edu.au Fax: 02) 9850 6578 Post: Centre for Emotional Health Clinic Level 1, Australian Hearing Hub 16 University Avenue Macquarie University NSW 2109 NEED AN INVOICE? Please tick the box on the front page if you need to be invoiced for the goods. Please note that we are not able to dispatch the items until the invoice is paid in full. NEED ASSISTANCE? If you require assistance with your order please contact our friendly administrative team on 02) 9850 8711 or email your enquiry to ehc.admin@mq.edu.au. For further information on the Centre for Emotional Health, visit our website: www.centreforemotionalhealth.com.au. HAVE YOU VISITED OUR WEBSHOP? All of our resources can be purchased from our secure online web-shop. http://accessmq.com.au/catalog/ RESOURCE DESCRIPTIONS CODE ANXB1 ANXB2 ANXB3 ANXB4 ANXB4a BOOK Overcoming Shyness and Social Phobia: A step-by-step guide Mastering Stress: A Lifestyle Approach Panic Surfing – Early Intervention Treatment Manual for Panic Disorder Helping Your Anxious Child (2nd Edition) CODE Helping Your Anxious Child – Children’s Workbook Treating Anxious Children and Adolescents: An Evidence Based Approach KIT ANXK1 Cool Kids Anxiety Program Kit ANXK1s ANXK1c ANCK1t Spanish Version Chinese Version Turkish Version ANXK2 Cool Kids Anxiety Program Kit (School Version) ANXK3 Cool Kids Anxiety Program Child Workbook Set ANXK3x Cool Kids Workbooks Set of Ten ANXB5 ANXK3xs ANXK3xc ANXK3xt ANXK15 ANXK16 Spanish Version Chinese Version Turkish Version Cool Kids ASD Anxiety Program Kit Cool Kids ASD Anxiety Program, Parent and Child Workbook DETAILS For adults suffering social anxiety; provides easy-to-follow steps designed to help control social fears and build confidence. For adults suffering general anxiety/overwhelming stress; provides easy-to-follow steps that help with relaxation, realistic thinking, assertiveness, and problem solving. For adults who have suffered panic attacks; teaches effective skills (using cognitive behavioral techniques) to overcome panic disorder. For parents who have an anxious child; covers a wide range of anxieties, from small phobias to crippling worries. Includes practical exercises and plenty of case examples. Hard copy of the Children’s workbook; also available to download (free of charge) after purchasing a copy of Helping Your Anxious Child (see book for instructions). Practical information for the mental health professional on helping anxious children and their families; provides general information on assessment, diagnosis, and theories. DETAILS All the materials a mental health professional needs to conduct Cool Kids group or individual treatment. Therapist's Manual describes how to conduct each session. Reference copies of Workbooks are included; each family requires copies of these. Kit contains: 1 x Cool Kids Child & Adolescent Anxiety Management Program Therapist Manual 1 x Cool Kids Child Workbook 1 x Cool Kids Parent Workbook Adaptation of Cool Kids for use within schools. Designed to be run by school counselors and related mental health professionals; Therapist's Manual describes how to conduct each session. Reference copies of Workbooks are included; each family requires copies of these. Kit contains: 1x Cool Kids Child & Adolescent Anxiety Management Program Therapist Manual (School Version) 1 x Cool Kids Child Workbook 1 x Cool Kids Parent Workbook One copy each of the Parent and Child Workbooks; to be used in conjunction with a therapist manual. Set contains: 1 x Cool Kids Child Workbook 1 x Cool Kids Parent Workbook Ten copies each of the Parent and Child Workbooks, allowing program to be conducted on larger scale. Set contains: 10 x Cool Kids Child Workbooks 10 x Cool Kids Parent Workbooks Variation of Cool Kids specifically for children who have an Autism Spectrum Disorder (including Asperger’s Disorder and High Functioning Autism) comorbid with anxiety. Contains Therapist Manual, Children’s and Parent’s Workbooks with handouts, activity guides and visual supports. Primarily targeted at children aged 812 but may be used outside of this age range dependent on the target child’s maturity and cognitive development. Kit contains: 1 x Cool Kids ASD Therapist Manual 1x Cool Kids ASD Child Workbook 1x Cool Kid ASD Parent Workbook One copy each of the Parent and Child Workbooks; to be used in conjunction with a therapist manual. Set contains: 1 x Cool Kids ASD Child Workbook 1 x Cool Kids ASD Parent Workbook ANXK16x Cool Kids ASD Anxiety Program, Parent and Child Workbooks Set of Ten ANXK4 Cool Kids (Adolescent) Anxiety Program Kit ANXK5 Cool Kids (Adolescent) Anxiety Program Kit (School Version) ANXK6 Cool Kids Anxiety Program Adolescent Workbooks (Chilled) Set ANXK6x Cool Kids Anxiety Program Adolescent Workbooks (Chilled) Set of Ten ANXK7 Cool Little Kids Toddler Program Kit ANXK7x Cool Little Kids Parent set of ten ANXK8 Cool Kids Anxiety & Depression Program Kit ANXK10 Cool Kids (Adolescent) Anxiety & Depression Program Workbook Set ANXK10x Cool Kids (Adolescent) Anxiety & Depression Program Workbooks Set of Ten Ten copies each of the Parent and Child Workbooks, allowing program to be conducted on larger scale. Set contains: 10 x Cool Kids ASD Child Workbooks 10 x Cool Kids ASD Parent Workbooks This package aids the mental health professional in conducting our treatment program for anxious adolescents. The therapist's manual describes how to conduct each session of the program including exercises and comments to assist successful implementation. Also included is one copy each of the parent companion and adolescent workbook. Contains: 1 x Cool Kids Child & Adolescent Therapist Manual 1 x Cool Kids ‘Chilled’ Adolescent Workbook 1 x Cool Kids Adolescent Parent Companion This package is an adaptation of the Cool Kids program for use within a school setting. It is designed to be run by school counselors and related mental health professionals. The therapist's manual describes how to conduct each session.. Also included is one copy each of the parent companion and the adolescent workbook. Contains: 1 x Cool Kids Child & Adolescent Therapist Manual – School Version 1 x Cool Kids ‘Chilled’ Adolescent Workbook 1 x Cool Kids Adolescent Parent Companion One copy each of the adolescent program parent companion and the adolescent workbook, designed to be used in conjunction with a therapist manual. Contains: 1 x Cool Kids ‘Chilled’ Adolescent Workbook 1 x Cool Kids Adolescent Parent Companion Ten copies each of the parent companion and the adolescent workbook, enabling professionals to carry out the adolescent anxiety treatment program on a larger scale. Contains: 10 x Cool Kids ‘Chilled’ Adolescent Workbook 10 x Cool Kids Adolescent Parent Companion For pre-school aged children who are a little more anxious, shy or inhibited, than most other children his/her age. The Cool Little Kids Program will help you to learn a number of skills and exercises to reduce excessive anxiety and increase confidence. Program Kit contains: 1x Cool Little Kids Parent Workbook 1x Cool Little Kids Therapist Manual Cool Little Kids Parent Workbooks only, for professionals wanting to carry out the program on a larger scale. Contains: 10x Cool Little Kids Parent Workbooks This Cool Kids Anxiety & Depression Program kit contains all the materials needed for a mental health professional conducting our treatment program with adolescents who are both anxious and depressed. The therapist's manual describes in detail how to conduct the program including exercises and comments to assist successful implementation. Also included is one copy each of the parent companion and adolescent workbook. Each family completing the program will require a copy of the age appropriate Workbook Sets. Reference copies of these are included with this kit. Each kit contains: 1 x Cool Kids Adolescent Anxiety & Depression Therapist Manual 1 x Cool Kids ‘Chilled’ Anxiety & Depression Adolescent Workbook 1 x Cool Kids Adolescent Anxiety & Depression Parent Companion One copy each of the Anxiety and Depression Adolescent Program parent companion and the adolescent workbook, designed to be used in conjunction with a therapist manual. Contains: 1 x Cool Kids ‘Chilled’ Anxiety & Depression Adolescent Workbook 1 x Cool Kids Adolescent Anxiety & Depression Parent Companion Ten copies each of the Adolescent Anxiety and Depression Program parent companion and adolescent workbook, enabling professionals to carry out the treatment program on a larger scale. Contains: 10 x Cool Kids ‘Chilled’ Anxiety & Depression Adolescent Workbook 10 x Cool Kids Adolescent Anxiety & Depression Parent Companion ANXK17 Study Without Stress Program Kit ANXK17x Study Without Stress Program Adolescent Workbooks Set of Ten ANXK11 Cool Kids Anxiety Child Outreach Program Kit Study Without Stress is designed to target the difficulties many students have in coping with the building stress during years 10, 11, and 12. The program teaches students cognitive and behavioural skills to manage the stress of the increases workload and pressure for performance associated with the HSC. Each kit contains: 1 x Study Without Stress Adolescent Workbook 1 x Study Without Stress Therapist Manual Ten copies of the Adolescent Study Without Stress workbook. Each kit contains: 10 x Study Without Stress Adolescent Workbook The Cool Kids Anxiety Management Outreach Program package includes all the materials that a mental health professional will need to support a family who is completing the self-help version of the Cool Kids Program known as “Helping Your Anxious Child”. This program is designed for primary school children only. The therapist's manual describes a program of activities that the child and parent complete at home independent of the therapist and describes how to conduct 10 telephone sessions with a parent to support their implementation of anxiety management skills with their child. Each family completing the program will require a copy of the text Helping Your Anxious Child and the accompanying Children’s Workbook. Each kit contains: 1x Cool Kids Child Anxiety Management Outreach Program Therapist Manual 1 x Helping Your Anxious Child 1 x Helping Your Anxious Child Workbook