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OVERDOSE REPORT FORM To be sent to the Department of Public Healths confidential fax number: 1 866 8678026 OR emailed to: surveillance.vigie.nrbhss@ssss.gouv.qc.ca Details for use on reverse Identification
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How to fill out overdose report formyesno
How to fill out overdose report formyesno
01
Gather all relevant information regarding the overdose incident, including date, time, and location.
02
Clearly document details about who was involved in the incident and any witnesses present.
03
Describe the types and quantities of substances involved in the overdose.
04
Note any medical interventions or actions taken to address the overdose.
05
Fill out the required fields on the overdose report form accurately and completely.
06
Review the completed form for any errors or missing information before submitting.
Who needs overdose report formyesno?
01
Healthcare professionals
02
Emergency responders
03
Law enforcement agencies
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What is overdose report form?
The overdose report form is a document used to report instances of overdose.
Who is required to file overdose report form?
Healthcare providers and facilities are required to file the overdose report form.
How to fill out overdose report form?
The overdose report form can be filled out online or submitted through mail.
What is the purpose of overdose report form?
The purpose of the overdose report form is to track and monitor overdoses for public health purposes.
What information must be reported on overdose report form?
The information that must be reported on the overdose report form includes details of the overdose incident, the individual involved, and the treatment provided.
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