SHRC Special Order Request Form
Want a product that the SHRC does not carry? No problem. We can special order any product from any of our suppliers at the wholesale price on your behalf. If you are interested in placing a special order through the SHRC please fill out the form below. Our Office Manager will be in touch with you shortly regarding pricing and special order information.

You can order products from the following four suppliers:

Sexy Living:
Ultra Love:
Pink Cherry:

Please fill out 1 form per product you are interested in ordering. If you have any questions about SHRC Special Orders do not hesitate to contact the Office Manager at

Information shared through this form is strictly confidential.

NOTE: This form is a request form only. Pricing, order and payment details will be finalized on an individual basis.

Email Address *
Email address will be used by the Office Manager to contact you with pricing and special order information.
Your answer
Wholesale Supplier *
Please pick the wholesale supplier which carries the product you are interested in. We can only order from the four suppliers listed below.
Product Name *
Please indicate the product name and preferred colour as listed by the supplier. (e.g. WeVibe 3 in purple)
Your answer
Product Number *
Please indicate the product number as listed by the supplier. (e.g. WE3005)
Your answer
Never submit passwords through Google Forms.
This form was created inside of Sexual Health Resource Centre. Report Abuse - Terms of Service