Monroe County Residents – Free Condoms

You can also order online by using the form at the end of this page. Applicants must be 18 years of age or older and also a Monroe County Resident.

Individual Personal Protection Package

An Individual Personal Protection Package allows the community to place an online order to receive free condoms. The Individual "PPP" consists of male and/or female condoms, lubricants, and educational material that promote condom use, protection from sexually transmitted diseases, and positive sexual health. Your "PPP" will be sent within one week of placing the order. See From Below.

How to Request Female Condoms

FC2 can be requested using the order form below.
Also, FC2 is an over-the-counter female contraceptive that can be prescribed to patients with no out-of-pocket expense, per the Affordable Care Act.

For additional information on female condoms visit FC2 Female Condom

Fields marked with an asterisk (*) are required.

Individual Personal Protection Package Form

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Address Information

Street Address *

City *

State *

Postal/Zip Code *

Demographics

Age *

Ethnicity *

Race *

Questions

How did you hear about us? *

Have you heard about PrEP? *

Would you like to receive dental dams? *

Would you like to receive female condoms? *

Would you like to receive non-latex condoms? (These condoms are for people who have allergies to latex) *

Disclaimer

The information obtained in this application will be used solely to keep a record of the people receiving the supplies from our office and will not be shared with anyone.

Confirmation *
By checking this circle below, I affirm that I live in Monroe County, I am an adult (18 or older), and I am making this request for myself.

Enter Confirmation Number

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