The following series of questions relate to reporting the administration of naloxone to either a suspected or confirmed opioid overdose.

Wherever possible the questions are designed to expedite answers to the required naloxone administration reporting requirements under the Maryland Department of Health, Behavioral Health Administration's Opioid Response Program.

It should take no more than 10 - 15 minutes to complete the report.

In addition, steps are taken to protect the identity of the individual completing the form.