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Sample Naloxone Standing Order and Protocol F O R M A N DA T E D G R O U P S I N C L U DI N G S C HO O L S, L A W E N F O R C E M E N T, C ORSEC TONS, AND OTHER G GROUPS WHO C ARMY NALOXONEIntroduction
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How to fill out sample naloxone standing order

01
First, gather all necessary information such as patient name, date of birth, and address.
02
Next, contact a prescribing healthcare provider to obtain a standing order for naloxone.
03
Fill out the standing order with the patient's information and any other required details.
04
Make sure to follow any specific instructions provided by the prescribing healthcare provider.
05
Once the standing order is completed, ensure it is signed and dated by the prescribing healthcare provider.
06
Finally, distribute the naloxone as needed according to the standing order.

Who needs sample naloxone standing order?

01
Individuals who are at risk of opioid overdose or who may witness an overdose event, such as family members, friends, or caregivers of opioid users.
02
Organizations or programs that work with populations at risk of opioid overdose, such as harm reduction agencies or substance use treatment centers.
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A sample naloxone standing order is a prescription written by a healthcare provider that allows certain individuals to obtain and administer naloxone in emergency situations when someone is experiencing an opioid overdose.
Healthcare providers such as doctors, nurse practitioners, and pharmacists are required to file sample naloxone standing orders.
To fill out a sample naloxone standing order, a healthcare provider must include their name, contact information, the name of the organization or healthcare facility, and specific instructions for the administration of naloxone.
The purpose of a sample naloxone standing order is to increase access to naloxone, a medication used to reverse opioid overdoses, and to empower individuals to respond to overdose emergencies.
The sample naloxone standing order must include the prescriber's information, specific dosage instructions, the expiration date of the standing order, and any required training or education for individuals who may administer naloxone.
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