BEcome A Member
Today

To join the coalition, please fill out our membership request form below and we will connect with you ASAP.

Membership is free to all!

First name*

Last name*

Organization

Organizational Areas of Support

Syringe Service Programs (SSPs)

Naloxone Distribution

Substance Testing Strips

FTIR Testing

Snorting Supplies

Smoking Supplies

Safer Sex Supplies

STI Testing

Medication Assisted Recovery (MAR)

Housing

Mental Health Support

Legal Aid

Advocacy

Organization Address

Organization Website

Email*

Phone

What is your Illinois House District number? *

Not sure? Click this link to find out!

Areas of Interest*

Overdose Prevention Sites (OPS)

Barriers to Recovery

Naloxone/Narcan Access

Syringe Service Programs (SSPs)

Ending Criminalization

Health Care/Treatment Access

All of the Above

Are you interested in becoming a monthly financial supporter of IHRRC? (this is NOT REQUIRED to join our membership)*

Yes

Would like more information

Do you agree to follow our community agreements? Your commitment is required to become a member. *

Yes

Click here to view IHRRC's Community Agreements

Do you have any potential conflicts of interest to disclose?*

To support transparency and community safety, please share any possible conflicts related to funders, pharmaceutical companies, law enforcement, government agencies, lobbyists, or treatment/hospital organizations. Sharing this will not affect membership. See our community agreements for more information.

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BEcome A Member Today

BEcome A Member
Today