School Narcan Request Form – Snohomish Health District
Instructions: Please include all the schools that you will be distributing Narcan to in one request. You will be mailed your unit(s) to the address provided on this form. If staff at your school needs training or educational materials for students, please indicate this below. If a unit is administered, please email firstname.lastname@example.org out to report the use and request a replacement. Please contact us when your unit is within three months of its expiration date.
Please contact email@example.com with any questions about Narcan distribution.