HIV/STD Prevention Program Free Condom Ordering Web Page

PLEASE BE ADVISED THE SERVICE IS FOR OF DETROIT, HIGHLAND PARK, and HAMTRAMCK RESIDENTS ONLY.

If you do not reside in Detroit, Highland Park, or Hamatramck you will not receive condoms.

Name*

Email

Address*

Address Line 2 (optional)

City

Select

Zip Code*

(non-Detroit zip codes will be rejected)

Type

Latex variety pack

Latex variety pack plus flavored

Non-latex (latex allergy (one type available - Lifestyles™)

Dental Dams

How Did You Hear About Us?

Select

Please note for privacy condoms will arrive in a plain brown envelope. Your email and the data on the order form will only be used internally and will not be shared with any third party.

By checking this box, I am confirming I live in Detroit, Highland Park, or Hamtramck. I am making this request for myself and agree these condoms will be used for personal use between consenting individuals and will not be sold.*