ASCO Period Pack Project

The ASCO Period Pack project aims to support individuals and families by providing printed materials, period products, and comfort items to address the physical, emotional, and social aspects of menstruation.

Each “Period Pack” includes:

- The Autism-Friendly Guide to Periods by Robyn Steward

- A colorful zippered pouch containing pads, pantiliners, and tampons

- Hand sanitizer

- Flushable wipes

- A microwavable stuffed animal heating pad

- A period tracker with stickers

- Social stories explaining menstruation

- Emotion cards to help express feelings, symptoms, etc.

- A list of slang words for periods

- A list of available medical resources for those needing additional support

Please complete the entire form below to apply for a period pack.

Email *
First and last name of individual filling out the form *
Email *
Phone *
Street Address  *
City *
Zip Code *
You must reside in one of the counties highlighted in orange to be eligible for an ASCO Period Pack. 
I acknowledge that the user lives in one of the counties that ASCO serves: Champaign, Delaware, Fairfield, Franklin, Knox, Licking, Logan, Madison, Marion, Morrow, Pickaway, and Union. *
Required
County You reside In *
Name of Period Pack user
 *
Age of Period Pack user
 *
Relationship (self, caregiver, parent, etc.)
 *
Please state reasons why receiving the ASCO Period Pack will benefit the user *
Would you like emotion cards included in your pack? *
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