Page 1 of 2
New Haven Glowhopper Go Waitlist
This New Haven Naloxone Distribution Map is still in beta. If you are interested in being included on this map or notified once we release the final map, fill out this form.
Are you a member of a distribution site interested in being included on the online distribution map?
*
Are you a member of a distribution site interested in being included on the online distribution map?
A
Yes
B
No
Full Name
Email
Phone Number
Organization
What platform would you prefer to be contacted?
What platform would you prefer to be contacted?
A
Email
B
Apple messages
C
What's App
D
Signal
Do you have any naloxone site location information you want us to include on the map?
Click to choose a file or drag here
Size limit: 10 MB
Submit
