Welcome to the request form for #MixItUpMG. Free condoms and at-home HIV test kits are available (while supplies last) to be mailed directly, and discreetly, to the home or desired address of any person over the age of 16 living in the 13 counites of North Central Health District.
All survey responses are confidential, and the information you provide is ONLY used to mail your test kit package and evaluate and improve this public health program. This is a mailing-based program, which requires you to provide your name and mailing address to successfully mail your package.
LIMITATIONS DO APPLY TO THIS PROGRAM.
1. Requests will only be fulfilled for addresses in NCHD's 13-county district (Baldwin, Crawford, Hancock, Houston, Jasper, Jones, Macon-Bibb, Monroe, Peach, Putnam, Twiggs, Washington and Wilkinson Counties). Any condom order submission from outside of NCHD will NOT be mailed.
2. One order per person can be placed every 30 days.
3. Condoms will only be sent to people over the age of consent (16 years old).
4. Condoms will only be sent to individuals and not businesses. For businesses wishing to partner with NCHD and give out free condoms please email Terry.Bolden3@dph.ga.gov.