Naloxone Click & Deliver Service

Please note this service is only applicable to those that live in Wales.

Welcome to Barod’s Naloxone Click and Deliver service. Naloxone is a life saving medication that can temporarily reverse the effects of an opioid overdose, including those related to heroin, methadone, morphine, buprenorphine and codeine. It can work within five minutes of being administered and can last between 20 to 40 minutes. It is crucial that anyone who experiences an overdose gains medical assistance, so therefore you need to call 999 and ask for an ambulance immediately.

If you have not undertaken overdose awareness and naloxone training before, or have not done so for a long time, we would highly recommend you complete training before submitting the form below and applying for a Take Home Naloxone Kit. You can access online training via Exchange Supplies.

To order your naloxone kits, please fill out the form below. You will receive one kit, along with a variety of harm reduction related resources, which will arrive at the address provided in plain packaging. The information you provide us will be kept confidential and will not be shared for any marketing purposes.

Your details

First name*

Last name*

Date of birth*

Address line 1*

Address line 2*

Town / City*

Postcode*

Phone number*

Email address

Where did you hear about the Naloxone Click and Deliver Service*

Who is the naloxone kit for?*

Which naloxone product do you require?*

What is your reason for choosing this product?*

Click here for more information on Nasal Naloxone ‘Pebble’
Click here for more information on Prenoxad

Is this your first kit?*

Training declaration

“I have undertaken the recommended Barod eLearning course relating to Overdose Awareness and Naloxone, or have previously received Naloxone training. I fully understand and aware of the main signs of an opioid related overdose, know how to respond effectively and administer naloxone.”

I agree to the training declaration

Please note: If you do NOT agree to the training declaration, a member of our team will give you a call on the mobile number provided, to facilitate training on how to identify an opioid overdose and effectively administer naloxone.

Consent

I agree to be contacted at a later date to update my training or to replace my naloxone supply if it goes out of date*

I am aware that if I have selected to receive Prenoxad, that the needle supplied is strictly for naloxone use*

I confirm that I am not to my knowledge allergic to Naloxone hydrochloride (or any of its ingredients)*

I consent to the sharing of anonymised information for the purpose of monitoring and evaluating the use and supply of Naloxone*

I have had the opportunity to ask all the questions that I need to ask about Naloxone and the possible risks and benefits (for more information you can chat to a trained support worker via our Live Webchat Service)*

I understand that Naloxone is a treatment specific drug that temporarily reverses the effects of an overdose and needs to be used solely for the purpose of saving lives*

I confirm that I am happy to receive a supply of Naloxone and am completing this form voluntarily and without pressure.*

Feedback

If you would like to provide any feedback regarding the application process or your experience of the service, please do so below.