Seat Belt Cover Request

Seat Belt Cover Request

Seat Belt covers are provided through a partnership with Leon County Sheriff's Office. Requests from Leon county residents with autism will be given priority.

If you are not already signed up as an FSU CARD client, we encourage you to do so at: www.fsucard.com

All clients must have a diagnosis of autism spectrum disorder. If the person is UNDER 9 years old without a formal diagnosis, but is showing signs of autism, they can register to become a client. We will send a follow up questionnaire to document signs of autism.

Name of person with autism*

Are you registered with CARD?

If you are not registered with FSU CARD, please go to our website: www.fsucard.com and click on "Become a Client".

*You must have a diagnosis of autism spectrum disorder to become a client. If the person is UNDER 9 years old without a formal diagnosis, but is showing signs of autism, they can register to become a client. We will send a follow up questionnaire to document signs of autism. *

Name of person requesting Seat Belt Cover*

Address*

Please put your full address, including city, state, and zip code

County*

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Phone Number*

Email*

How many?*

How many seat belt covers do you need?

Date you'd like to pick up

Our office will be open Monday through Friday 9:00 am – 4:30 pm. You can pick up your seat belt cover at any time during business hours. You will need to call the number on the sign posted on the front door, and someone will come and assist you.

2312 Killearn Center Blvd., Bldg. A., Tallahassee, FL 32309

Time you'd like to pick up

We will look for you to come during this time.

Are you willing to share photos of the kit in use*

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