Request Free Naloxone Access | Limen Vitalis
Request free naloxone and brief overdose-response education. No payment or insurance required. Availability depends on program supply and scheduling.
This form is not monitored for emergencies.
If someone is unresponsive or not breathing normally, call 911 now.
Limen Vitalis provides naloxone at no cost with brief overdose-response education through its signed San Diego Overdose Education and Naloxone Distribution (SD-OEND) Provider Agreement with the County of San Diego Health and Human Services Agency. No purchase, paid class, insurance, donation, or deposit is required. This brief education is not a certification course. Availability is subject to program supply and scheduled distribution.
Your Name
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First Name
Last Name
Email Address
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example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
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Email
Phone
City
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ZIP Code
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Request Type
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Please Select
Individual free naloxone access
Access for members of my household/community
Host inquiry for direct-to-individual distribution
Program question
Approximate number of individual recipients
Preferred days/times for follow-up
Accessibility or language accommodation request
Do not include medical records, diagnoses, prescriptions, patient names, drug-use details, housing status, Social Security numbers, payment information, or other sensitive personal information.
General message (optional)
I agree that Limen Vitalis may contact me to respond to this request. I understand this is not emergency care and does not guarantee inventory or a walk-in appointment.
*
I agree that Limen Vitalis may contact me to respond to this request. I understand this is not emergency care and does not guarantee inventory or a walk-in appointment.
I would like to receive occasional Limen Vitalis community-safety updates. I may unsubscribe at any time.
I would like to receive occasional Limen Vitalis community-safety updates. I may unsubscribe at any time.
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