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2025 Community Naloxone Usage Form

Community Naloxone Usage Form

Please complete this form if you were provided with or administered naloxone from Madison County Public Health. Answer the questions to the best of your ability. You may skip any questions or leave them blank.

If you have any questions, please email health@madisoncounty.govĀ orĀ overdose@health.ny.gov

Thank you for your participation!