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Get the free Take Home Naloxone Kit Distribution Form - Province of Manitoba

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FORM NUMBER: INTERNAL USE Telehealth, Seniors and Active LivingTAKEHOME NALOXONE KIT DISTRIBUTION FORM I. REPORTER INFORMATIONAL FORM SUBMITTEDDISTRIBUTION SITE CLIENT ID NUMBER (USED FOR ORDERING
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Take home naloxone kit is a package containing naloxone, a medication used to rapidly reverse opioid overdose.
Take home naloxone kits are typically distributed to individuals at risk of experiencing or witnessing an opioid overdose.
Take home naloxone kits typically include instructions on how to administer the medication in case of an opioid overdose.
The purpose of a take home naloxone kit is to provide a tool for individuals to quickly and effectively reverse opioid overdose, potentially saving lives.
The take home naloxone kit may require reporting information such as the date of distribution, the recipient's name, and the distributor's contact information.
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