West Central Health District

Mail-Order Condoms

Free condoms are available to be mailed directly to your home. You must be 18 years or older. You must live in the state of Georgia and reside within the West Central Health District. The counties included are as follows: Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, and Webster.

LIMITATIONS:

~ You must live in one of the counties listed above.
~ You must be over the age of 18.
~ Condom packs are limited to those listed in survey.
~ Each person is allowed one order per month.
~Orders will be mailed weekly.
~ Please contact us at (706) 321-6426 for questions or concerns.
1.NAME
2.MAILING ADDRESS
3.CONTACT INFORMATION

(Required.)
4.SELECT COUNTY OF RESIDENCE:
5.GENDER EXPRESSION:
6.AGE:
7.RACE/ ETHNIC IDENTITY:
8.SELECT DSIRED CONDOM PACK : (Choose only 1 pack)
9.HOW DID YOU HEAR ABOUT THE MAIL-ORDER CONDOM PROGRAM?
10.Would you be interested in receiving an At-Home STD test?
Current Progress,
0 of 10 answered