Mail Order Condoms
The North Georgia Health District is offering FREE mail-order condoms to anyone living within the following counties: Murray, Gilmer, Whitfield, Cherokee, Pickens, and Fannin. Condoms will be mailed in discreet, non-labeled packing to maintain your privacy.
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Email Address *
This will be used to let you know that order has been shipped
How Did You Hear About This Program *
Name *
Race *
Gender *
Mailing Address (with zip code) *
County *
Age *
Select Condom Pack Option *
Please select what type of condoms you would like mailed to you:
Phone number *
You will *ONLY* be contacted by phone if mailing address needs clarification
Do you want to be added to a reoccurring monthly condom order *
If you want to receive a monthly order of condoms please fill out the below optional questions to be added to the condom subscription service. Once added to the subscription list you will no longer have to request condoms your order will automatically be sent out on the first week of the month. The condom option you select on this form will be what is mailed to you monthly. You will receive an email notifying you of your order shipping to the email address you provided above. To be removed from the list once added please email hannah.becht@dph.ga.gov
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