* 1. Please enter the approximate date/time of your call to the poison center.

Date / Time

* 2. Were you satisfied with your call to the poison control center?

* 3. How did you find the Poison Help number when you needed it?

* 4. Do you have the poison control number saved into your cell phone now?

* 5. Would you contact the poison center again, if necessary?

* 6. If you would be willing to share your contact information for us to recontact you, please enter it below.