Report a naloxone kit distribution or overdose reversal with naloxone
In order to better track and monitor your program activities, please use the form here to log information about naloxone distribution and any overdose reversal data you might have.
Any data we collect will be shared in the aggregate form. No personal identifiers will be shared beyond your program. This information will help us understand community needs for naloxone and will inform future plans for naloxone allocations moving forward.
Additionally, overdose reversal data captured through this survey by syringe service programs will be reflected on a monthly basis in the NC Opioid Action Plan 2.0 Data Dashboard.
If you have any questions about the form or the tracking, please feel free to reach out to firstname.lastname@example.org.