Thank you for partnering with Safe Kids Orange and Safe Kids Chatham to make every child safer in vehicles. Please complete and submit the form on this page to place a referral for your client. We have a limited amount of available car seats throughout the year but we try to accommodate each request promptly and with the best of our ability. Please note that we will not be able to accommodate your request if this form is not filled out completely. This form will be checked a few times per week. We will respond to your request as soon as possible.

Please note that once an email is sent connecting you to the main contact at the distribution site you have selected to receive for your client’s  your education and seat, you will be responsible for following up and making an appointment with the main contact. We do not have the capacity to schedule appointments for each individual who makes a request.

For more information on this referral process and our Safe Kids Community Car Seat Program, please contact Anna Stormzand at anna.stormzand@unchealth.unc.edu.