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Car Seat Installation Appointment Request Form

To submit a request for an appointment with the Medford, Massachusetts Police Department Child Passenger Safety Unit (CPSU), please fill out the form below with as much information as possible.

Massachusetts Child Passenger Safety Law (as of July 2008)

  • Children must be in a federally approved child passenger restraint that is properly fastened and secured until they are 8 years old or over 57 inches tall
  • Children ages 8 through 12 must wear a properly fastened safety belt
  • A police officer can stop your vehicle if a child age 12 or under is not properly restrained

"*" indicates required fields

Name*
Email*
If unborn, type ‘unborn’
Installed or Uninstalled
MM slash DD slash YYYY
Is the seat registered*