These forms are for use by sites approved for participation in the Facility Overdose Response Box Program. If you are not yet registered in the Facility Overdose Response Box Program, information on registering and participating can be found here.
Have you just received your Facility Overdose Response Box?
- Learn about the contents and how to prepare your overdose response box for use here.
Mandatory Forms (must be submitted to BCCDC)
Naloxone Administration Information Form (please complete and submit after each overdose response)
Supply Order Form (use to re-order supplies for your overdose response box, or to order training supplies)
Optional Forms (for site use only - do not submit to BCCDC)
Naloxone Inventory Log (used to document changes in your naloxone inventory and to monitor supply levels)
Return to Naloxone Home Page