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New Car Seat & Car Seat Check Requests

Please fill out the form below if you are in need of a new car seat OR if you need one of our Child Passenger Seat Technicians to check your current car seat or booster seat. You will receive a confirmation email after submitting and a staff member will reach out to you within 72 business hours.

New Car Seat & Car Seat Check Request Form

Please complete this form only if you are requesting a car new seat or need a check or your current car seat or booster seat. If you need diapers, transportation, or any other request, please click here. A staff member will contact you within 72 business hours (this does not include weekends).

Healthy Babies Client?
Preferred Method of Contact
Healthy Start Client?
What other agencies are you accessing?
Do you own a vehicle?
Are you using public transportation?
Can you safely travel to us to receive the car seat or car seat check?
Is the child already using a car seat?
Please select the following (you may choose more than one):

Please Note: This information is strictly confidential and any personal information will not be shared.

Thanks for submitting! We have received your request. Please be sure to check your spam folder if you do not receive a confirmation email from us.

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