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Condom of the Month Club - Change of Address Request

Name*
First Last
Old Address*
Street Address City State / Province / Region ZIP / Postal Code
New Address*
You must live in the DFW area to be eligible for this program.

Street Address City State ZIP Code
Phone*
All change of address requests will be voice verified.
Email
Name
This field is for validation purposes and should be left unchanged.

Condom of the Month Club - Cancelation Request

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
All cancelation requests will be voice verified.
Email*
We're sorry to see you go. Please help us improve our service by letting us know why you decided to cancel.*
Your responses will be kept confidential and will not be shared with any other party. Responses will only be used to help improve HELP's free Condom of the Month Club service.
Cancelation Reason - Other*
Please describe your reason.
Name
This field is for validation purposes and should be left unchanged.

Join the Condom of the Month Club!

Condom of the Month Application

Name*
First Last
Address*
You must live in the DFW area to be eligible for this program.

Street Address City Texas ZIP Code
Phone*
All online applications will be voice verified.
Email*
We guarantee 100% privacy. Your information will not be shared.
Email Newsletter Opt-in
- Subscribe me to HELP Center's monthly newsletter
Ethnicity*
Other Ethnicity*
Gender*
Sexual Orientation*
Other Reason*
Age*
Consent
I agree to the privacy policy.
Email
This field is for validation purposes and should be left unchanged.

Volunteer with HELP!

The Health Education Learning Project could not serve our community and implement the important programs we offer without a tremendous amount of volunteer support. Volunteer opportunities for each of our programs is different and varies according to the current program activities. Thank you very much for your willingness to help us achieve our mission by giving of your time.

Volunteer

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone*
May we leave a message for you at this number?*
May we send a text to this number?*
Is there a specific program or volunteer opportunity are you interested in?
What days/times are you available to volunteer?
- Weekdays
- Weekends
- Daytime
- Evening
- Anytime
Have you ever been convicted of a felony? (We are required to conduct background checks are required for some volunteer work)*
Are you required to be listed on a sex offender registry?*
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PREP SUCCESS RATE
IN THE PREVENTION OF
HIV TRANSMISSION

FREE CONDOMS
DISTRIBUTED IN
TARRANT COUNTY

FREE HIV TESTS
CONDUCTED
SO FAR IN 2021

PrEP PATIENTS SEEN
SO FAR IN 2021

Condom of the Month Application

Volunteer

Cart

PREP SUCCESS RATE IN THE PREVENTION OF HIV TRANSMISSION

FREE CONDOMS DISTRIBUTED IN TARRANT COUNTY

FREE HIV TESTS CONDUCTED SO FAR IN 2021

PrEP PATIENTS SEEN SO FAR IN 2021

Newsletter

PREP SUCCESS RATE
IN THE PREVENTION OF
HIV TRANSMISSION

FREE CONDOMS
DISTRIBUTED IN
TARRANT COUNTY

FREE HIV TESTS
CONDUCTED
SO FAR IN 2021

PrEP PATIENTS SEEN
SO FAR IN 2021