Skip survey header

Overdose Response with Naloxone Training Request

Please use this form to request an Overdose Response with Naloxone training from the Southern Nevada Health District (SNHD).
1. Please provide contact information for training requestor:
This question requires a valid email address.
2. Type of Agency *This question is required.
4. Has your agency received naloxone training or naloxone from SNHD in the past? *This question is required.
This question requires a valid number format.
6. Does your agency prefer an in-person or virtual training? *This question is required.
7. Does your agency have access to a conference or meeting room that can accommodate the number of attendees? *This question is required.
7. SNHD can accommodate your training based on room availability at our location at 280 S Decatur Blvd, Las Vegas, NV 89107. Would your agency prefer a virtual training or to book a room at SNHD for the training session?
7. Will there be a TV with HDMI connectivity in the room where the training will take place? *This question is required.
8. What are your agency's preferred days/times for the training session? Please check all that apply. If you have no preference, please select "Any Time" for all days for which this would apply. 
Space Cell MorningMiddayAfternoonLate afternoonAny Time
Monday
Tuesday
Wednesday
Thursday
0%