Menu Close

Car Seat Installation Appointment Request Form

To request an appointment with the Medford Police Department Child Passenger Safety Unit (CPSU), please complete the form below with as much information as possible.

Before your appointment, please remove your car seat from its box, remove all tags and packaging, and have it ready to be installed. If you need assistance with two vehicles or have multiple car seats and/or bases that require installation, please indicate that on the form so we can schedule enough time for your appointment.

"*" indicates required fields

Name*
Email*
If unborn, enter ‘unborn’.
If unborn, enter 0.
If unborn, enter 0.
Installed or Uninstalled
MM slash DD slash YYYY
Is the seat registered*
A second vehicle needs a seat/base installed at this appointment