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Note: The number of kits requested may not equal the number of employees. Supplies are closely monitored. Request kits for use by all employees in common geographic areas, e.g. 1 per floor/building.
I hereby certify that I have completed the above-approved administration of Naloxone training programs. All those to whom I intend to provide a Naloxone kit for use in an overdose emergency have received training by the approved courses. I understand that there is additional information located at https://www.narcan.com that is specific to the Naloxone kits provided to me.
e.g. /s/ John Smith
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