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.

Please note: Winter Quarter orders in will be fulfilled on Mondays, Wednesdays, and Fridays.

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