Materials Order Form | Oregon Poison Center

Order poison center materials online with our simple Materials Order Form.

Instructions for ordering poison center materials

Oregon

1. View the list of the materials see what's available to Oregon residents and businesses (Tip: open the pdf list in a new browser window for easy reference).

2. Complete the form below to place your order.

3. The materials you requested will be shipped to the address you provided.

Please note:

We ask that you only order what you need and allow up to two weeks for processing. If you are on a deadline for the materials please indicate when they are needed in the order form below. Weather events, staffing demands and postal service delays may affect order fulfillment and delivery. If you need help with your order please call 503-494-7799.

Alaska

Alaska residents and business may order materials via Alaska Poison Prevention Program, a service of Alaska Department of Health and Social Services, Public Health Division.

Order Form

First Name

Last Name

Business/Organization Name

Phone Number

Address

Address 2

City/Town

State

Zip Code

Email

Requester’s Location

First set of Materials Requested

Number / quantity of material requested

Second Set of Materials Requested

Second Number / quantity of materials requested

Third Set of Materials Requested

Third Number /quantity of materials requested

Comments/Order Notes

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.