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For Poison Prevention Educators who were trained in person . If you were trained via the online training course click here.

Title *
 First Name *

Name of Organization
Last Name *
 Type of Organization *
Create Username *
 Address *
Create Password *
City *
 State *
 Zip *
Email *
County *
Phone * Alternate Phone

Optional Information
(For statistical purposes only)

Language(s) Spoken
Hold down Control key (Apple key on Mac)
to select multiple languages


Education Level Attained


Your Ethnicity
Gender *
 Age Range *
Occupation *


If other, please describe
Preferred Audience
Date of training *
Trainer / Training Center *

    * Denotes a required field



The Illinois Poison Center (IPC) is committed to protecting your privacy. Enrollment in the Illinois Poison Center's Poison Prevention Education Training Course requires you to submit personal information.

The personal information required for course registration will be used to:
  • Provide you with access to the online training course
  • Notify you of future outreach opportunities
  • Distribute educational materials
  • Communicate information about the IPC including services and special programs
The IPC does not disclose, give, or sell any personal information about our visitors, unless required for law enforcement or statute. Please contact Vickie Dance at vdance@ilpoisoncenter.org, or by phone at 312-906-6125 if you have questions.

> Read the complete IPC Privacy Policy



© 2007 Illinois Poison Center, a program of the Metropolitan Chicago Healthcare Council