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.

 

Brochures              
Helmet Fit Checklist  Helmet Fit Test     Bike Safety Tips Bike Safety Tips    Pedestrian Safety Tips      Pedestrian Safety Tips 
               
Gun Safety Flyer  Gun Safety Flyer    A Parent Guide to Home Safety A Parents Guide To Home Safety    Home Safety Checklist      Home Safety Checklist 
               
Playground Safety Tips  Playground Safety Tips    Falls Prevention Tips for Kids 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)       Poison Help Stickers (packs of 50)          
               
Banners (These 2 Banners are available for check out. (Dimensions are 31.5" x 89") They can be shipped via UPS or picked up here.)      
Bike Helmet Retractable Banner      Playground Safety Retractable Banner         
               

                                     

Date:   

Name:    

Business/Health Agency Name:    

Mailing Address:  (Need Physical Address for UPS)   

City:      State:   Zip:        

Phone Number:        

Email:    

Date Needed:     

 
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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.