Outreach Request Form

Request For: Campus Events, Educational Materials, Condom / Dental Dam / Lube Packets, Student Projects (Interview or Video), Etc.

All approved requests will receive a confirmation within 10 business days.

Please note:

Health Promotion Specific:

  • Campus Event, Presentation, or Education material requests must be submitted at least 10 business days in advance.
  • Barrier Necessities (condoms/dental dams/lube) and Student Projects requests must be submitted at least 3 business days in advance.

Counseling Specific:

  • Requests submitted with 30 days’ notice will be fulfilled as schedules allow. Any requests with less than 30 days’ notice will be given alternative outreach resources.
  • Please include alternative dates and times. 
  • Preference is given to those that schedule a semester in advance.
  • Only one request per program or event will be approved.


The following information will be sent via unencrypted e-mail. If you prefer, you can complete an event request form in our office.

Please enter your group information below and select "Submit" at the end of the form.