Community Naloxone Order Form Search Submit Search Print this Page Home » Health Information » Drug Use & Harm Reduction » Overdose Prevention & Naloxone » Community Naloxone Order Form Community Naloxone OrderNaloxone Hydrochloride Nasal Spray 4mg 2x4mg pre-assembled kit with Revive Narcan Training GuideOrder Date(Required) MM slash DD slash YYYY HiddenOrder Number Organization Name(Required) Current Naloxone Kit Stock(Required) Ordered By(Required) First Name Last Name Email(Required) Phone(Required)Total Number of Naloxone Kits and Training Guides Required(Required) CAPTCHA If you have any questions or concerns, please contact Harm Reduction at 613-345-5685 or 1-800-660-5853.