2025 MDPH First Responder Naloxone Report

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Event #: *

Officer Administering Narcan (Full Name) *

Employee ID Number *

Computer Number *

EPD Email Address:

Month *

Day *

Year *

OD Month *

OD Day *

OD Year *

OD Zip Code *

OD Hour (24 HR) *

OD Minute *

Gender of person who overdosed *

Male

Female

Male IDENTIFIES as Female

Female IDENTIFIES as Male

Unknown

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