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Take Home Naloxone Sites

Thank You for being a part of the Take Home Naloxone (THN) program. In this area you will find order forms, and how to update site details.

Updates for THN Sites

Step 1: RegisterStep 2: TrainingStep 3: Supplies

Site Management

Here you will find current versions of our required program forms.

For a full overview of the program and its requirements please refer to our RESOURCE FOR NEW THN SITES

1: Supply Order Form.

To receive naloxone kits and training materials please complete and submit this form.

Orders are processed every Thursday. Orders must be received by end-of-day 11:59pm Wednesday for processing that week, or orders will be carried over into the following week.

Please allow 10 working days for delivery and plan ahead to avoid shortages. Email naloxone@bccdc.ca for queries, follow-ups or changes to orders.

2: Kit Transfer Record

Please use this form when your registered THN site transferrs kits to any other site. This form is required for transferrs between registered sites and between registered and 'satellite' sites. 

IMPORTANT: Please ensure Satellite Siets have been registered with the BCCDC. All potential sites should use the Satellite Site Registration Form to obtain a site number. 

3: Overdose Response Information Form 

The overdose administration form is included inside every THN kit. The completion of these forms provides valuable information to the BCCDC which helps to inform our program.

Please assist clients with completing this form if a kit has been reported as 'used'. 

Email completed forms to naloxone@bccdc.ca or Fax to 604-707-2516

Use this form to let us know about any changes to contact information or personnel.

4: THN Distribution Reporting  

Distribution data provides valuable information to the BCCDC which can help to inform our program.

  • THN sites will be invited to share information on THN kits given out to individuals over a specified two week period annually.

Site coordinators will be contacted via email with an invitation to participate and additional details. Please see the FAQ for more information.

5: Contact Changes

  • Registered site can use the Contact Change Form to notify the program of any changes to contact information or personnel. 

Email completed forms to naloxone@bccdc.ca or Fax to 604-707-2516

Additional Resources

Additional resources for site staff can be found in our Health Professionals section.

Thank You

The Ministry of Health has released a Letter of Appreciation for the incredible contribution of naloxone trainers across the province!