Order to Dispense Naloxone (aka Narcan)
Naloxone is a prescription that is considered a 3rd party prescription, one that is dispensed to one person that can be used on a person whom it has not been prescribed. By signing this form you have received information on recognizing and responding to an overdose with the use of naloxone.

By completing this form I am acknowledging that I have received information on recognizing and responding to an overdose using naloxone. 

Participant agrees to hold Community Outreach Prevention & Education Network harmless for any incidents that may occur because of the use of the skills learned at this training  session. The materials contained in this presentation are provided for general information purposes only and do not represent endorsement for any product or manufacturer.

Training demo can be viewed at https://youtu.be/WMUBN6_gmJo
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