Enrollment Application

Periods can be expensive, and we’re here to help! If you need assistance in getting the feminine hygiene products that you need each month, the PAD Center can provide FREE products for you. To enroll in our free monthly subscription of feminine hygiene products, please fill out the following form:

Need help? Our referring partners can help you get signed up or provide you with an immediate response kit. You can also contact us at padcenterva@jrleaguelynchburg.org to get enrolled or ask any questions.