YPR Narcan Survey

Naloxone Survey
This survey is anonymous. We do not collect names or identifying information. Your responses help us secure funding and expand free naloxone access in your community.
YesNo

Thank you for responding in an emergency. The following questions help us understand how naloxone is being used in our community.
MyselfA friend or family memberSomeone I did not knowSomeone I support professionallyPrefer not to say
YesNoNot surePrefer not to say
Zip code where the emergency occurred:*
YesNoNot sure
YesNoI'm not surePrefer not to say
YesNoPrefer not to say
YesNo
Private residencePublic spaceBusiness locationVehicleOtherPrefer not to say
Hospital careDetox or treatmentPeer recovery supportHarm reduction servicesNo follow-up servicesNot sure
YesSomewhatNo
Fear of calling 911Lack of trainingNot enough dosesPanicBarriersOther
12-56+Prefer not to say
MyselfA friend or family memberSomeone I support professionallyJust in case/community safetyPrefer not to say
MyselfA friend or family memberSomeone I support professionallyJust in case/community safetyPrefer not to say
YesNoPrefer not to say
12-56+Prefer not to say
Location + Access
Your zip code:
Harm Reduction Hub boxYPR eventPartnering organizationFriendOther
Very easySomewhat easyDifficult
Risk Environment
YesNoPrefer not to say
YesSomewhatNo
Demographic of Naloxone Recipient
Under 1818-2425-3435-4445-5455+
FemaleMaleNon-binaryPrefer to self-describePrefer not to say
What barriers make it harder to access harm reduction supplies in your area?
Anything else you'd like us to know?
Should be Empty:

Naloxone Survey