Required fields are marked with asterisks (*)

Drug Reporting Tool

Have you or someone you know had an overdose or an unexpected drug reaction?

Our online Drug Reporting Tool is for you, or someone who supports you, to anonymously share about a bad or unexpected reaction to street drugs. The information you give us will help Durham Region Health Department look at local trends and send drug alerts to community agencies, who then share alerts with people who use drugs.

All questions in this form are confidential and anonymous. Please do not use names or include any information that could identify you or others in your answers.

Reporting information

Which best describes you?
 
Who had the bad reaction or overdose from the drug?
 
Approximately when did the drug reaction occur?
 
When did you get the drug?
 
What drugs do you believe were involved? Choose all that apply.
 
What was the reaction to the drug? Choose all that apply.
 

Additional information

Please do not include any identifying information or details, including names.



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