SHAC

Health Education & Prevention Department: Resource Center Request Form

NOTE: The following information will be sent via unencrypted e-mail. If you prefer, you can complete a Resource Center Request Form in our office.

Please enter your group information below and select "Send Information." All approved requests will receive a confirmation within 10 business days.

Note: Only one request per program will be approved. Please select one of the following:

Requested Materials - Educational







Requested Materials - Other

25 Condoms

Additional Information: