Online Order Form

Poison prevention materials are FREE to anyone within The Blue Ridge Poison Center ‘s service region. You may view our materials here. Help us 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.

Name
Address (please provide an address where you can receive packages)*
Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Packet includes poison safety information for all ages, 2 magnets, 2 stickers, and 2 wallet cards.
- Click here to request a family poison prevention packet (limit one per household)
Packet includes poison safety information for all ages, 2 magnets, 2 stickers, and 2 wallet cards.
Request Bulk Materials
I plan to distribute poison center materials as part of my work for: (insert name of school, organization, or business)
Are bulk materials to be used for an event?
If materials will be given away during a class or special event, please describe:
Number of Stickers
Number of Magnets
Number of wallet-sized first aid cards w/ key fob
Posters
You can help the poison center by displaying a poster in a public spot, such as a school, community bulletin board, or pharmacy waiting area. Please get permission from the business owner or agency before posting. Choose your poster(s) below:
- *NEW* Cannabis Edibles or Candy?
- Keep Her Safe (child)
- Turn on the Lights...(senior citizen)
- Read the Label (medicine label)
- All Questions are Smart Questions. (teen)
- Is it Candy or is it Medicine?
Number of Posters
How many of each poster selected above do you need? NOTE: There is a limit of 6 posters total per order. If you have a need for more, please contact the Education Coordinator: Kristin Wenger, 434-982-4386 or email klw2s@virginia.edu.
Check here to send a greeting card to a new parent.
- Card includes childhood poisoning prevention tips, a magnet, 2 stickers, and 2 wallet cards.
Send Greeting card to:
Name Mailing Address City State / Province / Region ZIP / Postal Code
From: (your name as you wish it to appear)
Comments

Please allow up to 3 weeks for your items to arrive.

If you need them sooner, contact Kristin Wenger:klw2s@virginia.edu or 434-982-4386.