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Overdose Response Training Request Form

Overdose Response Training Request Form - Chatham County

This form is to request a training on naloxone and overdose response from the Chatham County Public Health Department. This training is free of cost to any group in Chatham County.

Please contact Amanda McNamara, Opioid Overdose Prevention Coordinator, with any questions at amanda.mcnamara@chathamcountync.gov

1. Email This question requires a valid email address.

2. What kind of group are you requesting the training for?

Please enter an 'other' value for this selection.

3. What is the name of your group?

4. How many people do you want to attend the training?

5. Can you host the training?

Please enter an 'other' value for this selection.

6. What days and times are you available for the training? (The coordinator will reach out to you with specific dates and times)

Space Cell	Morning	Afternoon	Evening
Monday	Monday: Morning	Monday: Afternoon	Monday: Evening
Tuesday	Tuesday: Morning	Tuesday: Afternoon	Tuesday: Evening
Wednesday	Wednesday: Morning	Wednesday: Afternoon	Wednesday: Evening
Thursday	Thursday: Morning	Thursday: Afternoon	Thursday: Evening
Friday	Friday: Morning	Friday: Afternoon	Friday: Evening
Saturday	Saturday: Morning	Saturday: Afternoon	Saturday: Evening

7. Does your organization provide health or social services to people at risk of overdose and their networks?

8. Are you interested in distributing naloxone to community members?

9. Do you have any specific questions or ideas you want to have covered in the training?