Name of person requesting training
Maximum 255 characters
0/255
Email address
Name of organisation
Evidence of need (i.e. working with opiate users, experience of previous overdose)
How many people to be trained?
Who has been identified to deliver the training to you? How many kits are being requested?
Where would the kits be located? (at a specific location or by outreach staff)
Have you read the guidance document and the SLA and agree to sign up to the requirements including reporting on use of naloxone, expiry etc?
In the case of individuals being trained - have you read the expectation to report on use of naloxone, expiry etc?