WA State Naloxone By Mail Order Form

WA State Naloxone By Mail Order Form

Naloxone (A.K.A. Narcan) is a medication that reverses an opioid overdose.
People in Washington can order free naloxone by filling out this form. Naloxone By Mail is meant for people who can’t easily go to a community organization or a pharmacy to get a kit.

Other naloxone resources:
- Find free naloxone near you using the Washington State Naloxone Finder.
- Naloxone is free at pharmacies for people with Medicaid/Washington Apple Health insurance. Learn how to use health insurance to get naloxone at pharmacies in WA.
We accept one order per person a month, and up to three orders per household per month. This program is intended for individuals. This program is not for schools, businesses, organizations, or institutions.

This program is brought to you by The People's Harm Reduction Alliance and the WA Department of Health.

Click Next to place your order.

Your preferred name for shipping
Your street address or PO BOX number
Please include your apartment number if applicable
City
State
Zip Code
Email
example@example.com
We do not accept orders from schools, institutions, organizations, or agencies.

To apply for naloxone for your organization, please complete DOH's Naloxone Program Application.
Tribes, Tribal organizations, and Urban Indian Organizations can request naloxone using DOH's Tribal Naloxone Request Form.
To request training for your organization, please visit The People's Harm Reduction Alliance.
Any personal information you give us at The People's Harm Reduction Alliance is kept confidential. That means we do not share your name, address, or email with anyone. We will keep your name and email on file for 2 months so that we can reach you if there is a problem with your order, and then it will be deleted.

Optional Questions