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Narcan Training Request Form
Narcan training is provided by the Talbot County Health Department. Narcan is a drug used to reverse the effects of an opiod overdose. If you are interested in receiving this training please continue with this form.
*There is the option to receive just your certification or certification with the Narcan kit. Both options are free of charge.
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Email
*
Your email
Please enter your first and last name
*
Your answer
Please provide your phone number:
*
Your answer
Please choose a date - AT LEAST ONE WEEK FROM TODAY - that works for you. The Narcan team will follow up to confirm a date and time.
*
MM
/
DD
/
YYYY
Would you like to receive individual training or training for an organization?
*
Individual training
Training for an organization
If you are requesting training for an organization, please provide a brief description of your organization below, including its name, location, and expected number of trainees:
Your answer
Are you (and your group) interested in receiving a Narcan Kit with your certification?
*
Yes
No
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This form was created inside of State of Maryland.
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