Toggle navigation Load unfinished survey Resume later default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. Naloxone Distribution Cascade V2.3 Field (This question is mandatory) Site Choose one of the following answers Fruitvale Deep East Holdout Outreach West Contra Costa County East Contra Costa County (This question is mandatory) Have you received Narcan before? Yes No (This question is mandatory) Since the last time you visited us, did you use Narcan you received from us to reverse an overdose? Yes No (This question is mandatory) When you used your Narcan, did it reverse the overdose? Yes No (This question is mandatory) Do you still have at least one dose of Narcan? Yes No (This question is mandatory) Could you access your Narcan within a couple of minutes? Yes No (This question is mandatory) What happened to your Narcan? Choose one of the following answers I used it or gave it to someone for a reversal I lost it It was stolen It was confiscated I gave it away I got rid of it or threw it away (This question is mandatory) Do you want Narcan today? Yes No (This question is mandatory) We would like to train you to be able to administer Narcan in case you witness someone overdosing. Can we do that today? Yes No (This question is mandatory) Number of doses of naloxone given Only numbers may be entered in these fields. # intramuscular # intranasal Interviewer: Please refer this person to the trainer for training and click 'Submit'. Thank you! Interviewer: That's the end of the survey. Please thank the participant and click 'Submit'. Thank you! Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×
