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Fill out this form to receive free condoms in the mail

Policy Reminder: Each person can request up to two condom packages per month.
 

Have a roommate who needs their own supply? No problem — we’ll happily send a second order as long as they fill out the form using their own name.


Please note: This service is currently only available for PENNSYLVANIA RESIDENTS.

How did you hear about us?
Select Condom Type(s)
Gender Identity
Male, Cisgender
Female, Cisgender
Non Binary
Transgender Male
Transgender Female
Prefer Not to Answer
Self Describe
Race
White
Black/African American
Asian
Latinx
American Indian/Alaskan Native
Native Hawaiian/Pacific Islander
Prefer Not to Answer
Self Describe
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Josh Shapiro, Governor

Debra L. Bogen, Secretary of Health

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This project is funded, in part, under a contract with the Pennsylvania Department of Health.  Basic data for use in  this study were supplied by the Pennsylvania Department of Health, Harrisburg, Pennsylvania.  The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.

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