ID Archives - HELP Center for LGBT Health & Wellness

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Grief & Loss Counseling Group - Sign Up Request Form

Name*
First Last
Phone*
Email*
Newsletter Sign Up
- Subscribe me to HELP Center's monthly newsletter & program updates
Address*
Street Address Address Line 2 City State ZIP Code
When was the date of your loss?*
Briefly describe why you want to join this group.*
All information that you provide us will be confidential as required by state and federal law.
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Name
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COVID-19 Anxiety Counseling Group - Sign Up Request Form

Name*
First Last
Phone*
Email*
Newsletter
- Subscribe me to HELP Center's monthly newsletter & program updates
Address*
Street Address Address Line 2 City State ZIP Code
Briefly describe why you want to join this group.*
All information that you provide us will be confidential as required by state and federal law.
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Individual Counseling - Sign Up Request Form

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First Last
Phone*
Email*
We guarantee 100% privacy. Your information will not be shared.
Newsletter
- Subscribe me to HELP Center's monthly newsletter & program updates
Address*
Street Address Address Line 2 City State ZIP Code
Briefly describe why you are seeking counseling.*
All information that you provide us will be confidential as required by state and federal law.
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Transitioning Women's Support Group - Sign Up Request Form

Name*
First Last
Phone*
Email*
Newsletter
- Subscribe me to HELP Center's monthly newsletter & program updates
Address*
Street Address Address Line 2 City State ZIP Code
Briefly describe why you want to join this group.*
All information that you provide us will be confidential as required by state and federal law.
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Condom of the Month Club - Change of Address Request

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First Last
Email
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.
Name
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Condom of the Month Club - Cancelation Request

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Address*
Street Address Address Line 2 City State ZIP Code
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All cancelation requests will be voice verified.
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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.
Comments
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Join the Condom of the Month Club!

Condom of the Month Application

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

Street Address Address Line 2 City ONLY SHIPS TO 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 & program updates
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ID

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Grief & Loss Counseling Group - Sign Up Request Form

COVID-19 Anxiety Counseling Group - Sign Up Request Form

Individual Counseling - Sign Up Request Form

Transitioning Women's Support Group - Sign Up Request Form

Condom of the Month Application

Volunteer

ID Extra Large Lubricated Condom

ID Extra Thin Lubricated Condom

ID Frutopia Flavor Lubricant – Banana

ID Frutopia Flavor Lubricant – Cherry

ID Frutopia Flavor Lubricant – Mango Passion

ID Frutopia Flavor Lubricant – Raspberry

ID Frutopia Flavor Lubricant – Strawberry

ID Glide Personal Lubricant

ID Millennium Lubricant

ID Studded Lubricated Condom

ID Superior Feel Lubricated Condom

ID Velvet Silicone Lubricant

ID Xtreme Personal Lubricant with Friction Reduction Technology

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