Safe Sex Kits Request Form

Safe Sex Kits for Distribution
Organizations, businesses and clinics are able to request safe sex kits to distribute to team members and the public for free from the Bow Valley PCN. Request packages (40x kits) by filling out the form below:

Name: *

Email: *

Phone: *

Location/Organization: *

Types of kits:

#1: 2x Condoms, lube and local STI testing info
#2: 2x vaginal condoms, lube, dental dam & STI testing info

Safe sex kits can be requested in packages of 40. One package = 40x single kits. One single kit is appropriate for one person to take home, though visitors/staff are invited to take as many as they need.

Option 1: How many packages (40x traditional condom kits) would you like to request?

Option 2: How many packages (40x kits with vaginal condoms and dental dams) would you like to request?

Where would you like to pick-up the packages? *

Bow Valley Primary Care office, 107 - 1205 Bow Valley Trail, Canmore
Banff Library, 101 Bear Street, Banff

Please check operating hours at each location prior to arrival:
- Canmore PCN Office Hours 8.30 a.m.– 4:30 p.m. closed for lunch 12-1 p.m.
- Banff Library Hours, please check www.banfflibrary.ab.ca to confirm

Allow for 7 days to process your order. The PCN will contact you when your order is ready for pick-up.

Name