Injury Prevention and Control Program Order Form

Injury Prevention and Control Program
Order Form

If you have questions call 800.472.2286, select option 1.

Enter the quantity wanted for each item and the information requested below and press the "Submit" button at the bottom of the page.

Please limit quantities to 250 per item and allow 2 to 4 weeks for delivery.

Baby Safe Haven Materials
Safe Haven Law Flyer for Approved Locations	Hospital Checklist	Approved Location Checklist

Medical History Form	Approved Location Door/Window Poster	Baby Safe Haven Brochure

Brochures
Helmet Fit Checklist	Bike Safety Tips	Pedestrian Safety Tips

Gun Safety Flyer	A Parent Guide to Home Safety	Home Safety Checklist

Playground Safety Tips	Falls Prevention Tips for Kids	Poison Help Brochure

What You Can Do to Prevent Falls	Check for Safety

Educational Items
Poison Help Magnets (packs of 50)
Date: Name: Business/Health Agency Name: Mailing Address: (Need Physical Address for UPS) City: State: Zip: Phone Number: Email: Date Needed: P
Captcha * Enter the code shown on the left:

If you experience trouble submitting the form online, you can call your order in to the North Dakota Division of Injury & Violence Prevention at 800.472.2286 or 701.328.4536.