Request a Harm Reduction Kit
Request a kit of harm reduction supplies to support your health and safety.
First Name
*
Name
First Name
Last Name
Location
South Bend
Austin
Elkhart
Request Date & Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Supply Request
Place a mark next to the supplies that you are requesting.
Select the supplies you are requesting:
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Categories:
All
All
Safer Drug Use
Safer Sex Tools
Health Supplies
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Safer Drug Use
Hammer Pipe Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Glass Stem Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Snorting Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Needle Cleaning Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Narcan
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Fentanyl Test Strips
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Xylazine Test Strips
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Benzo Diazepine Strips
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Small Sharps Container
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Safer Sex Tools
Male Condoms
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Non-Latex Male Condoms
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Female Condoms
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Dental Dams
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Lubricant
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Flavored Lubricant
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Health Supplies
General Hygiene Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Female Menstrual Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Wound Care Kit
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Socks
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Mylar Blanket
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Hand Warmers
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Nylon Bags
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Safer Drug Use
Hammer Pipe Kit
Glass Stem Kit
Snorting Kit
Needle Cleaning Kit
Narcan
Fentanyl Test Strips
Xylazine Test Strips
Benzo Diazepine Strips
Small Sharps Container
Safer Sex Tools
Male Condoms
Non-Latex Male Condoms
Female Condoms
Dental Dams
Lubricant
Flavored Lubricant
Health Supplies
General Hygiene Kit
Female Menstrual Kit
Wound Care Kit
Socks
Mylar Blanket
Hand Warmers
Nylon Bags
Submit
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