Car Seat Request Form

Before completing this request form, please be sure you have read all information on the Car Seat Information page.

***CAR SEAT INSPECTIONS ARE BY APPOINTMENT ONLY***

Walk-ups WILL NOT be accepted at any of our inspection locations. We apologize for any inconvenience, but an appointment ensures a certified Child Passenger Safety Technician is available to assist you. We appreciate your understanding.

Please allow 48 hours for us to respond to your request. If you submit a request on a weekend or holiday, a longer response should be expected.

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Name: *

Street Address: *

City *

State *

Zip code *

County *

Phone Number: *

Email Address: *

Vehicle Make (i.e. Ford, Chevy, Nissan,etc.) *

Vehicle Model (i.e. Explorer, Malibu, Maxima, etc.) *

Vehicle Year *

Number of Car Seats: *

Child's age *

Child's weight (pounds) * lbs.

Please provide child's weight in pounds.

Child's height (inches) * in.

Please provide the child's height in inches.

Car Seat Manufacturer *

Car Seat Model Name *

Car Seat Model Number *

Preferred inspection location

Please select your preferred inspection location. If no selection is made, the default location will be Station 35 (Headquarters) located at 357 Fording Island Rd. For the addresses of the Fire District's additional inspection stations, please refer to the Car Seat Information page.

Date Requested:

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While we will do our best to accommodate your requested date, car seat installations typically require at least 48 hours advance notice for us to schedule a technician. If you are making a request on the weekend or a holiday, please be advised that it may take longer than 48 hours for us to respond. We appreciate your understanding!

Request Details: