Naloxone (Narcan) Training Enrollment Form
Thank you for registering for an upcoming Nalxone (Narcan) Training hosted by BRiDGES and the Central Region Addiction Resource Center.
For more information about BRiDGES, visit
. For more information about the Central Region Addiction Resource Center, visit
After you register, you will receive a link to the Zoom meeting the day before your desired training date!
*Please note, if none of these dates or times work for you, you can email Lauren at
to schedule a date and time that works with your schedule.
Email Address (Please Confirm Prior to Submitting)
Zip Code of Primary Residence
Desired Training Date
Tuesday, August 25th @ Noon
Which group best describes you? Please pick the one that best describes your reason for being trained.
Law Enforcement Personnel
Emergency Medical Staff (EMS)
Staff or Patron of Commercial Setting
Corrections Staff from State Prison or Local Jail
Have you ever been trained to utilize Naloxone (Narcan) in the past to reverse an opioid overdose?
Prior to attending the training, how comfortable are you responding to a possible opioid overdose?
Not comfortable at all.
Know the five steps and can step in confidently.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service