Hospital stationery order form

Items to re-order Tick all that apply.
Flyers
Choose one of our A5, 4-page pamphlets to be given to all new or expectant parents so they know how to register their bub.
• 
  Birth registration flyer—for all parents
• How many *
• 
  Our Kids Count register your bub flyer—specifically designed to support Aboriginal and Torres Strait Islander parents so they know how to register their bub
• How many *

Postcard

Our postcard is perfect for pre-natal appointments or classes.

• 
  Our Kids Count pre-natal birth registration postcard for expectant Aboriginal and Torres Strait Islander parents
• How many *

Posters

These posters are perfect to display in your patient waiting rooms, reminding the community of the importance of registering their bub.

• 
  Birth registration poster—A3 poster, reminding the community they need to register their bub and that the hospital won’t do this
• How many *
• 
  Birth registration poster—A4 poster
• How many *
• 
  Our Kids Count general poster—portrait poster
• How many *
• 
  Our Kids Count Aboriginal poster—landscape poster
• How many *
• 
  Our Kids Count Torres Strait Islander poster—portrait poster
• How many *
Contact details
1. Hospital name *
2. Postal address

   1. Address line 1 *
   2. Address line 2
   3. 1. Town, city or suburb *
      2. State *
      3. Postcode *
3. Your name We will mark the parcel attention to you.

   1. First name *
   2. Family name *
   3. Position title *
   4. Contact number *

      Email * We will send confirmation that we have received your request.

      By using this online service and providing an email address and contact number, I consent to the use of that email address and contact number by the Registry of Births, Deaths and Marriages (RBDM) to provide information and for contact by email or phone that relates to this request. I understand that it is my responsibility to ensure that I have nominated a secure email address for RBDM to send correspondence to, and I acknowledge that it is my responsibility to ensure the security of that information upon receipt of it.

Privacy notice
The Department of Justice and Attorney-General is collecting your personal information for the purpose of assessing your request under the Births, Deaths and Marriages Registration Act 2003. The information on this form may be provided to law enforcement agencies and to government and non-government agencies for verification of the data.