Request for Virtual Car Seat Check through King County Public Health We've received a request to schedule a virtual car seat check. We look forward to working with you! First, we need you to complete the following hold-harmless agreement. Please enter the requested information below, read the agreement, check the box, enter today's date, and click the submit button. Once you've submitted this hold-harmless agreement, watch for an email from a technician, usually within a couple business days. They will schedule a time with you. If you don't hear from a technician after a few days, please send an email to [email protected] to let us know. NOTE: The information provided will not be shared with anyone or used for any purpose other than to assist the you with the education that's been requested about proper car seat use.A car seat checkup is an educational opportunity. To fully participate in the appointment, please be sure to prepare in advance by reading the car seat and vehicle owner's manuals. Also, before the meeting, you should try installing the car seat on their own. If the baby isn't born yet, plan to have a doll or stuffed animal on hand in order to practice harness use.Your Name*Name of the person requesting a virtual car seat check (parent, grandparent, nanny, etc.) First Last Email* Enter Email Confirm Email City/State of Your Address* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Hold-Harmless Agreement* You must agree to terms of service listed below before the checkup.By checking the box, you state that you agree to hold harmless all parties involved in offering and conducting this car seat check. You understand that the sole purpose of this program is to help reduce the incidence of improper child safety seat installation; that this checkup is being provided as an educational service to the public; that this program cannot fully evaluate the quality, safety or condition of the child safety seat or any component of a vehicle, including the LATCH system, seats, safety belts and locations of air bags; and that this program cannot guarantee a child’s safety in a vehicle collision. You understand that it is important to read and follow the instruction manuals for both the vehicle and the car seat. For these reasons, I hereby release local, state and national passenger safety programs, certified CPS technicians, and any program participants or agencies for any present or future liability for any injuries or damages that may result from a vehicle collision or otherwise.Today's Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Other Information (Optional)If you'd like to share any additional details or provide information for the technician, please add it here.
