BMC All Staff Naloxone Training Registration BMC All Staff Narcan Training Registration Name* First Last Email* Please choose 1 training block to attend (drop-in sessions approx. 15 minutes each):* Monday, April 30, 2018, FGH Building 12 pm - 5 pm (820 Harrison Ave, Boston, MA 02118) I will not be able to make any of these dates, but I am interested in future trainings I will not be attending any of these sessions because I have already had in-person Narcan training How comfortable are you administering Narcan as a first responder?*Very uncomfortableUncomfortableNot SureComfortableVery comfortableHow comfortable are you teaching others how to administer Narcan?*Very uncomfortableUncomfortableNot sureComfortableVery comfortableHow would you describe yourself?*Medical providerNursePublic safetySocial workerCase ManagementSupport staffMedical StudentPublic health studentGraduate studentOtherAre you interested in getting a Narcan prescription at the end of this training?* Yes No (If so, please bring your medical insurance card and/or BUID information with you to the training)