Seminar Request
Please complete this form to request a live in-person seminar or virtual webinar for your school, organization or group; we will provide a one hour seminar with subsequent naloxone (Narcan) and fentanyl test strip distribution to interested participants.
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Email *
Organization / Group / School Name *
Organization City/Town *
Organization State *
What type of training are you looking for? *
Approximately how many people do you anticipate attending? *
How would you prefer to have the seminar provided? *
Desired location of seminar (only if in-person)
What days/times would you prefer to host a seminar? *
CONTACT INFORMATION
Please enter the information for the main contact person representing your school, organization or group
First Name *
Last Name *
Title
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