Agency Condom Orders - Talk, Test, Treat Central Florida | HIV Testing, Prevention , Treatment

Agency Contact Information

*Please note that we only supply to agencies or organizations.

Please fill out your organization's contact information and order request using the form below.

If you have any questions, please call us at 407-858-1400

First Name(Required)

Last Name(Required)

Title

Organization(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Extension

Fax Number:

Email Address(Required)

Order Requests

Indicate your order on the form below. The quantity specified should be the number of cases you would like for each item.

- Male Condoms
- Female Condoms
- Other Latex Barriers
- Lubricants

NOTICE: We make no assurances that we have the itemized products in stock. We reserve the right to:

- Deny any order in whole or in part;
- Adjust the quantity of orders; and
- Substitute items.

Male Condoms

ONE Legends 1,000 per case:

Lifestyles SKYN (latex free) 1,000 per case:

ONE Classic 1,000 per case:

ONE Flavors 1,000 per case:

Trojan ENZ 1,000 per case:

Trojan Magnum 1,000 per case:

Atlas Black 1,000 per case:

Female Condoms

FC2 Female Condom 100 per bag:

Other Latex Barriers

Sheer Glyde Dental Dams 100 per case:

Lubricants

ONE Move – Silicone-based 500 per case:

ONE Oasis – Water-based 500 per case:

Consent(Required)

I agree to the terms of use.(Required)

- All items ordered through this program must be provided FREE of charge.
- All of these items will be distributed solely within Central Florida
- The staff, volunteers and other agents of my organization may not knowingly furnish these items for re-distribution outside of Central Florida.
- I will cooperate with staff from the Florida Department of Health in evaluating this program.