Contact Us and Receive Information on Pregnancy Prevention or Join Our Mailing List

Join the TAG mailing list to receive newsletters, program notices or request information on having an educational program at your school or agency. If you are a Teen in need of transportation assistance to a sexual health care appointment, please complete the contact information and transportation request below.*

*If you are requesting transportation assistance to attend our teen health workshops or visit a sexual/reproductive healthcare provider, please be sure to allow time for us to mail the requested items to you BEFORE your scheduled workshop/appointment date and time.

Name:*
First Last
Email:*
Enter Email Confirm Email
How Can We Help You?*
Are You A:*
- Parent
- Youth
- School Personnel
- Youth Provider
Transportation:*
- $10 Stewarts Gas Card: I do not have access to Greater Glens Falls Transit
Address:*
Street Address Address Line 2 City State ZIP Code
I am looking for information on the following:
Phone:*
Town:
This can be arranged by calling our office during normal business hours to 518-761-0300 ext. 31107 or 31119 or by completing section 1 and 2 or 3 depending on your choice of bus or taxi. Please make sure you have completed the e-mail and/or mailing address above for delivery of tokens and vouchers. E-mail delivery of taxi vouchers will require a printer.
Date of Appointment:*
Month
Day
Year
Additional Info:

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