Puberty Kit Request Form
These kits are intended for adolescents with Down syndrome who are entering puberty or in their first years of puberty. The products in this kit are intended to be samples for use or demonstration of use. If you have a concern about the materials or ingredients in the products (e.g. skin condition or allergy) please indicate in the area provided and alternative accommodations will be made if needed. *Images are an example of products and items may vary slightly
Female Kit
Includes social stories about body changes and menstruation, as well as products to use and sample. Postcard included with online resources for additional information.
Male Kit
Includes social stories about boy changes, important hygiene tips, consent, and privacy. Product samples for hygiene included, as well as online resources for more materials.
Your name (person filling out request)
*
First Name
Last Name
Name of person with Down syndrome who will be using the kit.
*
First Name
Last Name
Kit you are requesting
Female
Male
Age of person with Down syndrome
*
Email (if we should have questions about your form and to send shipping confirmation)
*
example@example.com
Address (at this time, kits are only available to families in West Virginia)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list any allergies or products you prefer to avoid:
Please type the symbols in the box provided
*
Submit
Should be Empty: