Condom Heart

Resident Condom Ordering Form

You can choose from a variety of packages.
You can only select 1 package of condoms and/or a package of oral barriers (dams).
All of our condom packages contain 12 condoms
10 oral barriers/dams per package

Please mail me a Sex it Smart package (condoms and/or oral barriers (dams) Please mail me a Sex it Smart package (condoms and/or oral barriers (dams)

Yes

No

By checking "Yes" above, you are confirming that we can mail you a Sex It Smart package at the address provided.

Packages Available Packages Available

Regular Lubricated (ONE® and Kimono® Thin)

Non-latex lubricated (Lifestyle®)

Large (Lifestyle®)

Variety Pack (Regular Lubricated ONE® and Kimono® Thin, unlubricated Lifestyle® and Lifestyle® Large)

Oral Barriers/Dams

Should you require additional condoms please contact us at OPHSexualHealth@Ottawa.ca

You can access more oral barriers at the Sexual Health Centre or the Site Office located at 179 Clarence Street.

Name

Age - select one

Select One Select One

Male

Female

Neither of these options describes my gender.

City of Ottawa Address

Apartment

City

Postal Code

Please provide us with your email address if you would like to receive communications from the Sex it Smart team

How did you hear about Sex It Smart?

Form Builder

Resident Condom Ordering Form

By checking "Yes" above, you are confirming that we can mail you a Sex It Smart package at the address provided.

Should you require additional condoms please contact us at OPHSexualHealth@Ottawa.ca

You can access more oral barriers at the Sexual Health Centre or the Site Office located at 179 Clarence Street.

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