Alabama Poison Control Order Form | Children's of Alabama

Materials are available to Alabama residents free of charge. Help APIC serve you best by filling out the request form below completely. We will never share your name or contact information with any other person or organization without your permission.

Organization Name:

Organization Type:

Event Type:

First Name

Last Name

Address

Address 2

City

State

Zip Code

Phone (US)

Poison Home Packet [includes help phone sticker and magnet] (Max. 2):

Poison Help Phone Stickers (Max. 250):

Spanish Poison Help Phone Stickers (Max. 250):

Poison Help Magnet (Max. 250):

Spanish Poison Help Magnet (Max. 250):

Pill Planner (Max.10)

Posters

Look-A-Like Poster (Max. 5):

Snake Poster (Max. 5):

Candy vs Medicine Poster (Max. 5):

Drug Disposal Poster (Max. 5):

Keep Her Safe Poster (Max. 5):

Poison Center Handle (Max. 5):

Perfume, Nail Polish Poster (Max. 5):

Comments:

Locations

Patients & Visitors

Ways to Help

Posters

I WANT TO...

PATIENTS

PHYSICIANS

MEDIA

AWARDS & RECOGNITION

CONNECT