Request Period Products
Please only fill out this form if you are in Ontario and in need of menstrual products and are unable to access them. Each Period Pack contains 11 pads and 7 tampons, enough for at least one cycle. If you require any modification (for example, pad-only packs), please leave a comment at the bottom of the form. Please leave any questions or concerns at the bottom of the form or email directly. Please note that unfortunately at this time we are only able to service Ontario, however, we are happy to provide you with assistance in finding support if you live somewhere else.
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Full Name *
Contact information *
Please provide your phone number in case there are issues with the delivery of products  *
Street name and number; apartment number if necessary  *
Postal code *
What city/town are you located in? *
How did you hear about us/find this form?
Any additional comments to help us better serve you
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