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Submit Reversal
Please enter the reversal information below, your information is vital and helps us save lives!
Name (not required)
Email Address
Approximate age of person who was revived *
City reversal took place *
Zip code reversal took place *
Number of doses used *
Date of reversal *
What kind of Naloxone was used?
Naloxone from end overdose was used
Naloxone from a different program was used
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