FREE Condoms

top of page

HOME
ABOUT US
- STAFF & OFFICERS
- CONTACT US
REGIONAL PROVIDERS
- PROVIDER RESOURCES
HIV/AIDS INFORMATION
ONLINE RESOURCES
GIVING
REQUEST FOR PROPOSALS
FREE Condoms
More

Use tab to navigate through the menu items.

Fill out this form to receive free condoms in the mail

Each order ships with 8 condoms in total. You may choose multiple types, but the total quantity mailed will be 8 condoms.

DUE TO LIMITED FUNDING, WE CAN NOW ACCOMMODATE A MAXIMUM OF TWO CONDOM PACKAGES PER ADDRESS PER MONTH.

THANK YOU FOR YOUR UNDERSTANDING

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

First Name*

Last Name*

Address*

Address - Suite/Apt/Lot/Etc (optional)

City*

State

Zip / Postal Code*

How did you hear about us?*

Email (optional)

Select Condom Type(s)*

Classic/Regular

Extra Large

Flavored (assorted) - Regular Size (LIMITED AVAILABILITY)

Ribbed / Studded - Regular Size

FC2/Female Condoms (Sent in packs of 2 only). Please note in the comments if you've used them before or they will not be included in the order.

Check to CANCEL your Order

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

Notes / Special Requests (Optional)

Josh Shapiro, Governor

Debra L. Bogen, Secretary of Health

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.

bottom of page