Reusable Menstrual Product Survey

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All products will be picked up at the Schenley Quad at tables located in the patio area between Amos and McCormick Hall. The products will be available first-come first-serve, but we will do our best to provide your selected product.

NOTE: DUE TO HIGH DEMAND, ALL MENSTRUAL PADS HAVE BEEN CLAIMED. WE ARE ONLY ABLE TO SUPPLY MENSTRUAL CUPS NOW.

What is your name? *

What is your Pitt email? (abc123@pitt.edu) *

Would you prefer to receive a menstrual cup or a reusable pad? *

Menstrual Cup (DotCup Brand)

I would like to be placed on a WAIT LIST for a Reusable Pad (LunaPad Brand, comes with three inserts)

Please select a pick-up time for your product. *

Wednesday (Feb 24th) 11:00AM -- 1:00PM

Wednesday (Feb 24th) 4:00PM -- 6:00PM

Friday (Feb 26th) 1:00PM -- 3:00PM

I cannot pick-up during any of these times

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