The Illinois Naloxone Standing Order allows eligible entities to provide naloxone to any requesting person with the intent to respond to a suspected opioid overdose without a direct prescription.

Please submit the requested information below to express a need for naloxone.

The information you provide is HIPAA protected and is only accessible by Evanston Public Health Officials.

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Phone Number

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* 5. Are you an Evanston resident?

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* 6. The naloxone can be picked up from the Evanston Civic Center during business hours, Monday - Friday.

What time of day would you prefer to pick up?

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