WSHA Order Form

Order naloxone educational materials for your hospital at no cost!

WSHA has partnered with the Starts with One campaign, an opioid misuse prevention campaign from the WA Health Care Authority, to develop three new materials for hospitals:

• Naloxone rack card (now available in 7 languages)
• Naloxone prescription handout (now available in 7 languages)
• Conversation guide on responsible opioid use

Fill out the form below to place an order and request specific quantities for your health care facility. The campaign will ship requested quantities directly to your facility, free of charge. 

Orders close at the end of August 2026, and will be mailed in September.

Naloxone Rack Card (for patients)

This folding rack card explains what naloxone is, why carrying it matters, how it works, and where to get it.

Suggested use cases: hand to patients prescribed opioids, distribute in ED settings, and/or place in waiting rooms or exam rooms.

Click here to preview the rack card's full content. 

Naloxone Prescription Handout (for patients)

This postcard-sized patient handout covers the basics of naloxone and explains that it is standard to receive naloxone along with an opioid prescription. 

Suggested use cases: for providers and pharmacists to give patients along with their opioid and naloxone prescription. 

Click here to preview the handout's full content. 

*If your hospital has a pharmacy, consider ordering extra prescription handouts to display near the prescription pickup area.

Conversation Guide Table Tent (for providers)

This foldable conversation guide stands upright on desks, offering a quick-reference checklist for providers to use when discussing responsible opioid use with patients receiving an opioid prescription.

Suggested use cases: place on provider desks, use during patient appointments when prescribing opioids, and keep in exam rooms to prompt conversations.