Naloxone Feedback Survey

Thank you for reviewing the webpage. Please provide your feedback in this quick survey so we can improve our programming on overdose preparedness and naloxone. All information is confidential.

1. Please select the industry that best represents your organization. *This question is required.

2. How likely are you to use the information you received from this naloxone webpage in your workplace?

3. As you learned on the webpage, naloxone is a medication used for the emergency reversal of suspected opioid overdose. Which one of the following best describes your organization’s current position regarding stocking naloxone on site?

4. Which of the following factors might influence your organization to consider implementing naloxone in your workplace? Please select all that apply.

An employee being seriously injured on the job due to use / misuse of opioids
Employee requests for naloxone
Recommendations from associations specific to workplace health and safety
Positive reviews or recommendations about naloxone from peers or colleagues
A workplace fatality due to an opioid overdose
Fact sheets or case studies about how naloxone can save lives
Reduced cost of naloxone
Other - Write In Please enter an 'other' value for this selection.

4. Overall, how feasible has it been to integrate naloxone into your workplace practice?

4. Overall, how feasible do you think it would be to integrate naloxone into your workplace practice?

4. Which of the following barriers do you think your organization might face when it comes to the stocking and administration of naloxone in your organization? Please select all that apply.

5. Which of the following, if any, would you like to receive from the National Safety Council to help your organization with implementation of naloxone in your workplace? Please select all that apply.

6. Is there any other feedback you'd like to provide?

Naloxone Feedback Survey - California