This form is for First Responder and Public Safety agencies to request Naloxone (Narcan) kits from DCCCA’s Naloxone Program at no cost.

If you are another organization, or individual, use this form.

Requests made through this link from agencies not identified as a public safety or first responder agency will not be fulfilled.

Please be advised this program offers free Naloxone (Narcan) only to agencies in Kansas and availability is contingent upon continued Federal and State Funding.