Help From Home DVD Set Order Form

Help From Home DVD Set Order Form

TriWest is pleased to present Help From Home, a free resource designed to provide deployment support to our nation's military Service members and their families.

Help From Home includes two video presentations: Getting Home...All the Way Home, TriWest’s original post-deployment DVD and On the Homefront, a new video that features practical, first hand advice from military families who have lived through deployment transitions and reintegration.

Members of the news media who would like a copy of the DVD set, contact Kristen Ward or Richard Gray at TriWest Healthcare Alliance: (602) 644-8496 or (602) 564-2399

Enter Requester Information
Fields marked with * are required.

* First Name:

* Last Name:

Rank:

Title/Position:

Organization:

Telephone:

* Address 1:

Address 2:

* City:

* State:

* ZIP Code:

* E-mail Address:

* Quantity:

Intended Use:

For orders greater than 50, please SELECT 50, then state the requested quantity below and indicate how the DVD set will be distributed to Service members and families.

How did you hear
about the DVD:

Have you viewed
the DVD prior to ordering?

Yes