Materials Order Form | Oregon Poison Center

Open the list of the materials to view what is available to Oregon residents and businesses. Complete the form below to place your order. We do ask that you only order what you need and allow up to two weeks for processing. If you need help with your order please call 503-494-7799.

Alaska residents and businesses, please order via Alaska Poison Prevention Program, a service of Alaska Department of Health and Social Services, Public Health Division.

First Name

Last Name

Address

Address 2

City/Town

State

Zip Code

Phone Number

Business/Organization Name

Order Information

Please make sure to specify both the item(s) and the quantities for each item. The list of available materials for order is linked to at the top of the page.