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Condom Pack Order Request Form

This is where you can request SHFPACT Condom Box Packs for your organisation or event.

Please note that these resources are available only to organisations based in CANBERRA. Each pack includes condom usage instructions, SHFPACT clinical services information and contains water-based lube and two condoms. The box design may be different from the shown image. Fields marked with an * are required.

Your Details

Please type your full name.

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Description of service/event. SHFPACT staff may be able to attend your event. Please call us on 6247 3077 to request this.

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Please let us know how many packs you may like.

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Are the Condoms for demonstration purposes only? SHFAPCT can supply expired condoms (stock permitting) for demonstration purposes i.e. educational demonstrations in showing the correct technique for using condoms.

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Any additional information about your request?

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Can you collect your order from our clinic at Level One, 28 University Avenue, Canberra, City? Please note that if you cannot collect, you will be asked to contribute to the cost of a courier.

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