Alabama Poison Center

APC On-line Order Form

The Alabama Poison Center is pleased to offer free Poison Prevention Guides to residents of Alabama. Our goal is to prevent accidental poisonings throughout the state.
Ordering your Poison Prevention Guide is the place to start!

Order now by completing this simple on-line order form. It could save your child's life!
(Please allow 3 weeks for delivery. If you need a Poison Prevention Guide earlier, please contact the Alabama Poison Center at 1-800-462-0800).

Last Name: First Name:

Address:
Address:

City:

State: (Select One)

Zip Code:

Telephone Number:

E -mail Address:

How many Poison Prevention Guides do you need?

Please specify number:

Where do you plan to use the Poison Prevention Guide(s)?
(Select all that apply)
Home
Work
School
Other (please specify):

Have you ever called the Alabama Poison Center before?
Yes
No

Privacy Statement
The above information will only be used to deliver your requested material. The Alabama Poison Center does not release names submitted to any other group, and individual names will not be used on any reports created by the Alabama Poison Center to track distribution of poison prevention material or the use of our services.

Click the Send button to submit your information. Thank you.