Thank you for asking for our help in educating the people of Kaua`i about safer sex practices, the facts about Sexually Transmitted Diseases. Please complete the request form below and our Director of Prevention Services will be in touch within 2 business days. Mahalo! (an honorarium is appropriate when possible for services)

(* indicates the field is required)

* Name:

Company/School/Organization you are requesting services for:

* Phone:

* Email:

* Age group the presentation should be adapted for

Service Requested:

Please let us know when you would like this presentation and what concerns or hopes you might
have for us: