Boston Public Health Commission: Overdose Rescue Training Request

Boston Public Health Commission: Overdose Rescue Training Request

The City of Boston offers education and training to opioid users, their families, and community partners that work or may come into contact with people at risk of overdose. This training is available in English and Spanish. When receiving this training, participants will learn: (1) about the risk factors for overdose, (2) how to recognize the signs of overdose, and (3) how to administer naloxone and perform rescue breathing in response to an overdose. Please fill out the following form to request a training from the Boston Public Health Commission.
Name of agency or organization:*
Contact person:*
Phone number:*
Email address:*
What language would you like this training to be given in?*

EnglishSpanish
Would you like this training to be virtual or in-person at your location?*

VirtualIn-person
If you selected in-person, what address would you like the training to be held at?
Is this training for....*

StaffClientsOther
Is this an initial or follow up training?*
How many people will be getting trained?*
About how long would you like the training to be?*
What's the best day of the week to do a training?*

MondayTuesdayWednesdayThursdayFriday
What's the best time of day to do a training?*

MorningAfternoonEvenings
Has an overdose already occurred in your agency?*
How did the agency respond to the overdose?*
What worked well and what needs improvement?*
What existing overdose response policy does your agency have that needs to be evaluated or updated?*
Where are the locations within your agency that may present heightened overdose risks or complicate overdose response? (SRO’s, Locked Bathrooms)*
What is your protocol for staff if they witness an off-site overdose while working?*
Do you currently have naloxone kits available?*

YesNoI don't know
If yes, how many naloxone kits do you have? (Answer N/A if none)*
What is the expiration date on the naloxone kits that you have?*
Should be Empty: