Safer Sex Supply Request Form

Please use this form to request a restock of a Safer Sex Supplies station or to request supplies for personal use. Please complete this form in its entirety.

These supplies are only for University of Chicago students.

Note: Autumn Quarter orders in will be fulfilled on Mondays, Wednesdays, and Fridays. During the week of Thanksgiving, orders will be fulfilled on Tuesday, November 26.

If you have any questions, please contact Emily Schulze Scott (eschulze@uchicago.edu).

Question Title

* What is your UChicago email address?

Question Title

* Please select the reason you're filling out this form:

A Safer Sex Supply Station needs to be restocked

I would like to request personalized supplies for my own use to be picked up at Student Wellness