Naloxone Enrollment and Record of Use Form - New Mexico

Naloxone Enrollment and Record of Use Form - New Mexico

Naloxone Enrollment and Record of Use Form is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.

FAQ

Q: What is the Naloxone Enrollment and Record of Use Form?
A: The Naloxone Enrollment and Record of Use Form is a document used in New Mexico to enroll in a naloxone program and keep track of naloxone usage.

Q: What is naloxone?
A: Naloxone is a medication that can reverse the effects of an opioid overdose.

Q: Who can use naloxone?
A: Naloxone can be used by anyone, including family members, friends, and bystanders, to help reverse an opioid overdose.

Q: How do I enroll in the naloxone program?
A: To enroll in the naloxone program, you need to fill out the Naloxone Enrollment and Record of Use Form and submit it according to the instructions provided.

Q: Why should I enroll in the naloxone program?
A: Enrolling in the naloxone program allows you to receive naloxone for free and provides education on how to recognize and respond to an opioid overdose.

Q: What do I need to record on the form?
A: On the form, you will need to record the date and time of naloxone use, the location of the overdose, the gender and age group of the person revived, and the reason for the overdose.

Q: Is the naloxone program available outside New Mexico?
A: The availability of naloxone programs may vary by state. It's best to check with your local health department or healthcare provider to see if a naloxone program exists in your area.

Q: How long is naloxone effective after administration?
A: Naloxone is effective for a short period of time, typically around 30 to 90 minutes. It is important to seek medical help immediately after administering naloxone.

Q: Is naloxone safe to use?
A: Yes, naloxone is generally considered safe to use and has minimal side effects. However, it is important to read and follow the instructions provided with the naloxone product.

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Form Details:

  • Released on July 1, 2017;
  • The latest edition currently provided by the New Mexico Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.

Download Naloxone Enrollment and Record of Use Form - New Mexico

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