Harm Reduction Material Request Form
Use this form to request no cost harm reduction tools and information. Available for Maine Residents only
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Narcan Nasal Spray Training Video: You must watch this video to receive your Narcan Kit.
Do you have a Maine address? *
Did you watch the Naloxone training video above? *
How would you like to receive your free Narcan Kit and related harm reduction information? *
How would you like to receive your Fentanyl Test Strips?
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Would you like to request a Deterra medication deactivation bag?
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Please provide your name and address if you are requesting harm reduction items be mailed to you.
Please provide your preferred method of contact if you requested to arrange a pick-up time for harm reduction items.
What county do you reside in? *
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This form was created inside of Healthy Acadia. Report Abuse