Opioid Overdose Recognition, Prevention & Narcan Administration Virtual Training Request Form
Please fill out the following form as carefully as possible. After submission, an Outreach Coordinator at End Overdose Together will reach out to review the details and finalize the training for your organization.

* VIRTUAL TRAININGS ARE AVAILABLE TO ALL ORGANIZATIONS IN THE UNITED STATES *

In light of the current situation and rapidly changing conditions of COVID-19, we are shifting on-site trainings to VIRTUAL TRAININGS using a video communication platform.

Trainings are typically 1 hour and can be scheduled 8am-8pm 7 days/week virtually over Demio. Each training attendee will receive a FREE kit in the mail that contains two doses of Narcan and materials to safely administer it. Certificates are provided upon completion of training.

Please note that our monthly trainings open to the public take place on the 1st and 4th Monday of Each Month at 2:00pm. Registration is required. Please email training@endoverdosetogether.org to register and receive the training link.
Email address *
Provider/Agency/Organization Name *
Virtual Training Request Date and Time 1 *
Trainers are available 7 days a week from 8am-8pm
Virtual Training Request Date and Time 2 *
Trainers are available 7 days a week from 8am-8pm
Virtual Training Request Date and Time 3 *
Trainers are available 7 days a week from 8am-8pm
Is training for employees or clients? *
Contact Person *
Full Name
Contact Person Email *
Contact Person Telephone Number *
Provider/Agency Web Address
Number of individuals to be trained *
Provider/Agency Complete Physical Address *
Is there a training/in-service day, staff meeting day, or member meetings that are typically held at your agency/organization? If so, what day and time? *
Are you familiar with the Demio platform? (We will send a link for all attendees to register and join the training via Demio) *
Please provide any additional information that would be helpful for us to know pertaining to your training request.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy