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FORM NUMBERHealth, Seniors and Active LivingTAKEHOME NALOXONE KIT TRACKING FORM I. REPORTER INFORMATION MHSC USE ONLY1.SITE NAME2.SITE ADDRESS4.POSTAL CODE5.PROVINCE/TERRITORY3.CITY/TOWN/VILLAGE6.FORM

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What is take-home naloxone kit?

Take-home naloxone kit is a life-saving medication used to reverse opioid overdoses.

Who is required to file take-home naloxone kit?

Healthcare providers, pharmacies, and individuals who are at risk of opioid overdose or who care for someone at risk.

How to fill out take-home naloxone kit?

The kit typically includes naloxone medication, instructions for use, and information on opioid overdose response. It should be administered according to the instructions provided.

What is the purpose of take-home naloxone kit?

The purpose of a take-home naloxone kit is to provide a means for individuals to quickly respond to an opioid overdose and potentially save a life.

What information must be reported on take-home naloxone kit?

The kit should include information such as the name of the individual receiving the kit, the date of distribution, and instructions for use.

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