Car Seat Check Request Form

The Ault Fire Department and Ault Police Department have certified car seat technicians available to assist with car seat checks. While we make every effort to keep technicians available on all shifts, your anticipated appointment date may need to be adjusted based on availability. Please bring all car seats, car seat manuals, and vehicle manuals with you to your appointment, if possible. During your visit, a certified car seat technician will check the current installation and provide education on proper car seat installation and use.

Name:

Email Address:

example@example.com

Phone Number:

Format: (000) 000-0000.

Preferred Method of Contact (check one):

Vehicle Year / Make / Model:

Number of Children:

Number of Car Seats:

Car Seat Make and Model(s):

Do you have the car seat manuals? (check one):

Have any of the car seats been used previously? (check one):

Specific questions or concerns to be addressed at your appointment:

Preferred date(s) to meet with a technician:

Disclaimer: Car seat checks are provided as an educational service by certified car seat technicians. Technicians do not install car seats for caregivers and do not assume responsibility for the installation. Final responsibility for correct installation, use, and compliance with manufacturer instructions and applicable laws remains with the caregiver or vehicle owner.