Request Club Outreach

Haymarket Pole Collective delivers club outreach supplies through our direct aid program. Interested in having us visit your club? Want to pick up supplies directly? Let us know below, by filling out this form.

Currently, due to funding, we are only available to serve these counties: Multnomah, Washington, Columbia, Clackamas, Yamhill, & Marion.

Any and all support provided by HMPC is strictly confidential and will not be shared with anyone. If you have any questions or concerns please email tenisha@haymaretpole.com or call our outreach staff at 971-395-9301

Name

First Name

Last Name

Phone

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Request direct aid items below

If there are any additional supplies you think we should provide please put suggestions here:

Masks

Hand sanitizer

Surface wipes

At home covid tests

Body wipes

Narcan

Fentanyl test strips

Clean sharps

Sharps containers

STI tests

HIV tests

Lube

Condoms

Tampons

Pads

Diva cups