Kansas Infertility Prevention Project Portal


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KIPP Site Order Form

Bureau of Disease Control and Prevention
Sexually Transmitted Disease Program
1000 SW Jackson, Suite #210
Topeka, KS 66612-1274
Phone: (785) 296-5596                                          Fax: (785) 296-5590

* Denotes required fields.



STD Medications:

Number Requested

 Tablets
 Bottles
 Tablets
 Bottles
 Vials
 Vials
 Syringes


Supplies:

Number Requested

 
 
 Kits





Questions: Please contact via email Stephanie Green or at (785) 296-5595.