New York State Condom (NYSCondom) Program

Terms of Use

By placing this order, I agree to each of the following without reservation:

  • All items ordered through this program must be provided free of any charge and without any requirement or obligation on the part of those persons to whom my organization provides these items.
  • All of these items will be distributed solely within New York State.
  • The staff, volunteers and other agents of my organization may not knowingly furnish these items for re-distribution outside New York State.
  • Information on the proper use of condoms, either through printed materials or other instruction, will be made readily available to those individuals to be furnished these items.
  • I will cooperate with staff from the New York State Department of Health in evaluating this program.

Do not complete this request form unless a New York State Condom Program Organization Information and Attestation (OIA) has already been submitted which specifically authorizes you to make NYSCondom requests. You must specify below the e-mail address that was provided on the OIA.

Your Contact Information

(Cannot be a P.O. Box)

Shipping Information

(Cannot be a P.O. Box)

Order Requests

Indicate your order on the form below. The quantity specified should be the number of cases you would like for each item. If, for example, you want to order 10,000 lubricated Lifestyles® condoms, you should indicate 10 in the Quantity/Cases field, because there are 1,000 of these condoms in each case that is shipped.

NOTICE: We make no assurances that we have the itemized products in stock. We reserve the right to:

  1. Deny any order in whole or in part;
  2. Adjust the quantity of orders; and
  3. Substitute items.

In offering these products free to the public, we are not making any endorsement of them nor are we making a qualitative assessment of them as compared to other products that may be commercially available.

Please allow approximately 3-4 weeks for the initial order.

Male Condoms

Beyond Seven® 1,008 per case

Durex Maximum Love® 1,000 per case

Lifestyles® Assorted Colors, Lubricated 1,000 per case

Lifestyles Ultra® Lubricated 1,000 per case

Lifestyles Ultra Sensitive® Lubricated 1,000 per case

Lifestyles Ultra Thin® Lubricated 1,000 per case

Trojan-Enz® Lubricated 1,000 per case

Trojan Magnum® 1,000 per case

Temporarily out of stock

Trojan® Non-Lubricated 576 per case

Female Condoms

FC® Female Condom 100 per case

Other Latex Barriers

LIXX® Dental Dams 100 per case

Sheer Glyde® Dental Dams 100 per case

Finger Cots Case of 1,440

Lubricants

ID Glide® 10ml "pillow packs"    500 per case

Temporarily out of stock

Slippery Stuff® Gel 3ml packets    500 per case

Wet® Light 3ml foil pouch    500 per case

Please Note

Some documents on this page are saved in the Portable Document Format (PDF). If it's not already on your computer, you'll need to download the latest free version of Acrobat Reader.