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COLLATERAL REQUEST

Collateral requests from the Arkansas Minority Health Commission are defined as health-related requests for educational literature and promotional items for outreach events. The purpose of collateral requests are to increase awareness of hypertension, stroke and other disorders that disproportionately impact minorities. 

 

Guidelines

If you are interested in receiving health education materials from the Arkansas Minority Health Commission, please note that:

  •  Requests should be made a minimum of 7 days prior to the event.
  •  A collateral request form should be completed for all requests for educational/promotional items by an individual/organization. All lines should be completed.
  •  The collateral request form should be emailed to AMHC health specialist LaCoya Stewart at LaCoya.Stewart@arkansas.gov or faxed to the AMHC at 501-686-2722. 
  •  Promotional items only cannot be requested. 
  • Tobacco, heart disease/stroke sheets should be included in all orders. 

 

Screenings provided

If screenings will be provided at your health event, the AMHC requires the following documents to be completed in addition to the collateral request form:

*These forms must be submitted to the AMHC Health Specialist. 

 

Pick up/ Delivery

Once your collateral request is filled, you will be notified for pick-up or your health education literature will be mailed (if specified on request form). All documents that you submit to the AMHC (pre-event, screening data, post event and collateral request) will be filed by the agency and entered into its annual report. 

To download and complete the AMHC collateral request form, click the link below: 

Collateral request form

If you have a copy machine, the AMHC has a number of its health sheets listed here that you may print at your leisure.