Naloxone Usage Reporting Form

This form helps us understand how the naloxone we provide is being used in our community. All responses are completely anonymous. 

* Required Fields

In addition to requesting a replacement kit from GO Health, naloxone is available for pickup today at all pharmacies in New York State without a prescription. If you have prescription coverage through your health insurance, the Naloxone Copay Assistance Program will cover your copay up to $40. No enrollment is needed.

You can also send a text to 716-225-5473 to have free naloxone mailed to you by our partners at the Erie County Department of Health.

Comments are closed.

Close Search Window
Translate »