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New Form for Reporting Overdose Reversals - Google Forms

Have you used Naloxone recently? We want to hear from you!

It takes less than 60 seconds to answer 3 questions on our Overdose Reversal Reporting Form. Your answers significantly benefit programs like ours & allow us to continue to participate in state-funded programs & distribute Naloxone to individuals like YOU!

If you are reporting more than one overdose please fill out one form per incident.

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