LGBT Foundation - Play Pack Order Form

Please complete this form if would would like to order a FREE Play Pack from LGBT Foundation.

After this page you will have the opportunity to sign up for our FREE SMS sexual health test reminder service.

Consent for us to process information:
Consent to contacy if faults w/ Playpack:
Consent to contact re order new Playpack:
Request Type:



Postal Address:
Postal Postcode:
Current Age:
Gender Identity:
Gender Identity - Please State:
Your gender identity the same at birth?:
Sexual Orientation:
Sexual Orientation - Other, Please State:
Ethnicity:
Ethnicity - Other, Please State:
Who do you have sex with?:
Describe partner(s) you have sex with?:
What kinds of sex do you do?:
Do you engage in any of the following?:
Method(s) of protection use during sex?:
Method(s) of Protection - Other, Please:
How often do you engage in group sex?:
Method(s) of protection use in group sex:
Group Sex Protection - Other:
How often do you engage in Chem Sex?:
Which chems do you use?:
Chems You Use - Other, Please State:
How do you take your chems?:
Method(s) of protection during chem sex?:
Chem Sex Protection - Other:
Who measures/administers your chems?:
Have you been tested for HIV before?:
If tested before, when was recent test?:
Are you living with HIV:
Been vaccinated for Hepatitis A & B?:
Are you living with Hepatitis C?:
have you been tested for STI's before?:
Most recent STi test in months:
Been diagnosed with an STI in past year?:
Confident & comfortable testing for HIV?:
Like to contact you about our services?:
Been vaccinated for HPV?: