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2. First Name
3. Last Name
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Phone Number 2
14. Email Address
18. Contact Preferences:

    1. Contact by Phone
    2. Contact by Email
19. Type of Service:

    1. Installation
    2. Inspection
20. Type of Seat:

    1. Car Seat
    2. Booster Seat
22. Best time to Call or Email
26. Additional Information:
28. Once form has been submitted an officer will contact you to set up an appointment. Appointments will be held at the Police Department located at 4450 W. Streetsboro Road.
30. If you have any other questions please contact the Police Department 330-659-9500
32. Thank you from the Richfield Police Department.
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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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