Naloxone HCI Nasal Spray Kit Request Form

Naloxone requests through this form are prioritized for community partners distributing directly to individuals at risk of overdose. Requests for general use, events, or non-target populations may not be approved.  

Please refer to the next section for a list of priority partner organizations eligible for naloxone distribution.  


Naloxone Order Update: Direct Shipping is Here 🚚

Thank you for your continued partnership and commitment to increasing life-saving overdose prevention and response services across Utah.

We’re excited to share a major upgrade to how naloxone is distributed statewide—orders are now shipped directly to you through our vendor, Padagis. No more pickups, no more extra steps.

What this means for you:

🚚 Direct shipping statewide – delivered right to your door

⚡ Faster turnaround – most orders arrive within 2–3 business days once Carla has approved/processed your order

📦 More supply per order – you can now request up to 10 boxes (120 kits)

This change is all about making access easier, faster, and more consistent—so you can focus on getting naloxone where it’s needed most.

We truly appreciate the work you’re doing every day to support overdose prevention in your communities. We’re excited to keep building this system with you.

Best,
Carla Arancibia
carancibia@utah.gov
385-258-6741 (call or text)

If you're interested in ordering Fentanyl/Xylazine Test Strips, please click on this link for the FTS/XTS Request Form.

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Please select the organization type that best represents your agency:

This request form is intended for community partners distributing naloxone directly to priority populations (e.g., individuals at risk of overdose, first responders, community-based organizations, and public health partners).   *
Please list the name of your organization/company/organization/department: *
Primary contact name: *
Primary contact email address (please avoid using personal emails): *
Primary contact phone number: *
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