Exit Use Naloxone to save a life Use Naloxone to save a life Question Title * 1. Do you live in Ohio Yes No what is your first and last name and your address? Question Title * 2. I watched the video provided on the website Yes No Question Title * 3. What is your age? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 4. Which race/ethnicity best describes you? American Indian or Alaskan Native Asian / Pacific Islander Black or African American Hispanic White / Caucasian Other prefer not to say Multiple ethnicity / Other (please specify) Question Title * 5. What is your gender? Female Male prefer not to say Question Title * 6. How helpful was the content presented at the event? Extremely helpful Very helpful Somewhat helpful Not so helpful Not at all helpful Question Title * 7. Would you like to receive additional information about Naloxone? Please provide your contact info below. Phone call Text Email No thank you. Include phone number or email address Question Title * 8. Is this the first naloxone (Narcan) kit you have received? Yes No Question Title * 9. If no, what happened to the first kit? The kit was used on another person who was over dosing and they survived The kit was used on another person who was over dosing and they did not survive The kit was used on me. The medication kit expired other Question Title * 10. What is the intended use for naloxone? If I overdose If a friend or family member overdoses If I see someone overdose Done