HRT Injection Kit Request
Queer in Canton is now offering FREE Hormone Replacement Therapy Injection Kits for Intramuscular/ IM Injections and Subcutaneous/ SubQ Injections, and sharps containers. Your request is 100% anonymous and will not be shared with anyone. 

You are welcome to pick up a kit during our open hours (Mon-Fri, 10 AM - 5 PM - check social media for any abnormal closure dates) at the Queer in Canton Community Center (2663 Cleveland Ave NW, Canton, OH 44709). Fill out this form to notify us of your request, so we can make sure we have what you need. If you have any questions, feel free to reach out at info@queerincanton.com. 

*We are no longer offering drop-off services, apologies for any inconvenience. 

Intramuscular/ IM Injection Kits include:
(10) 22 Gauge - 1.5 inch needles -- for drawing & injecting
(5) syringes
bandaids
gauze pads
alcohol pads

Subcutaneous/ SubQ Injection Kits include:
(5) 22 Gauge - 1.5 inch needles -- for drawing
(5) 25 Gauge - 5/8 inch needles -- for injecting
(5) syringes
bandaids
gauze pads
alcohol pads
Sign in to Google to save your progress. Learn more
Which kit do you need?
Do you need a sharps container?
Clear selection
How can we contact you in case we are out of what you need?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Queer in Canton. Report Abuse