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Which program would you like to join?*

Expression of interest – Period products

Organisation details

Organisation name*

MMM location

MMM category*

Check this link to confirm your MMM status.

Anticipated program utilisation

What number of clinics will utilise period products?*

What number of communities will utilise period products?*

What is the estimated population of women (and those with a uterus) who you anticipate will utilise the program across all clinics and/or communities?*

Primary contact

Secondary contact (optional)

Delivery address

Agreements & Considerations

Please review the following Agreements and Considerations to participation in the NACCHO Period Product Program

For stock management purposes, NACCHO may schedule 2–3 monthly ordering ‘windows’ during which orders can be placed.

If requested, we agree to provide feedback to NACCHO on how the program is being distributed, the preferred products and program uptake.

To notify NACCHO as soon as practicable if the received products are faulty or damaged.

I understand there may be minimum and maximum quantities of products available.

We have considered the storage requirements of the ordered products at our service.

We have considered how distribution of the ordered product will be undertaken, noting there is no FTE provided with this program.

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