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Condom requests

Request Free Condoms

Fields marked with an * are required
  • Please note: Condom donation stock is currently limited. The information provided on this form will be used to determine if your request is eligible for a donation. Priority will be given to target audiences as determined by the SHQ Strategic Plan. Condom requests for demonstration or distribution in schools can only be filled if they are submitted by a staff member (e.g. teacher, nurse).
  • Name * Required
  • Address * Required
    Free resources are only available to organisations based in Western Australia
  • Date Format: MM slash DD slash YYYY
  • Please enter a number from 0 to 50.
    If you are running a larger event or ordering for multiple sites and require more than 50 condoms, please email [email protected] and a member of our team will contact you to discuss your request.
  • Are the Condoms for demonstration purposes* only? * Required
    *USE OF CONDOMS FOR DEMONSTRATION PURPOSES ONLY SHQ can supply expired condoms (stock permitting) for demonstration purposes i.e. educational demonstrations in showing the correct technique for using condoms. After completing this form, SHQ will require you to sign a condom liability form, no expired condoms can be disseminated until this additional form has been finalised.
  • Can you collect your order from SHQ in Northbridge? * Required
    Please note: if you cannot collect, you will be asked to contribute to the cost of postage