Naloxone Distribution Program Eligibility Application

Thank you for your interest in naloxone distribution.  In order to participate in the Ontario Naloxone Program, your organization must meet specific eligibility criteria. Once you complete this application, a representative from Durham Region Health Department will contact you.

Agency contact information:

Information is collected and used under the authority of the Health Protection and Promotion Act R.S.O. 1990 cH.7, s.5. This information is collected and used for the purposes of substance use prevention and harm reduction, reporting and ensuring eligibility for the program. Questions about this collection and use of information should be addressed to Durham Region Health Department, Manager, Health Information, Privacy and Security at 605 Rossland Rd E., P.O. Box 730, ON, L1N 0B2, (905) 668-7711.