Resources Request Form

In order to help prevent overdoses and keep our community safe from accidental and intentional misuse of medications, we provide the resources below free to Berks County residents.

Please fill out the form below to let us know which of these products you would like to make available to your group.

Medication Disposal Bags for safely and easily neutralizing medications so they can be disposed of in the household trash

Medication lock boxes for safely storing and organizing medications.

Narcan Opioid Overdose Reversal Kits for reversing an overdose caused by an opioid drug.

Resources Request Form

Please fill out this form to let us know which resources you would like us to provide to your organization. All items are available at no cost.

"*" indicates required fields

Name*

First Last

Email*

Phone*

Please select all the items you would like to make available to your group*

Narcan Kits (Includes 2 doses of Narcan and other emergency response supplies)

Medication Lock Boxes

Medication Disposal Bags

How many medication disposal bags would you like?

How many Narcan Kits would you like?

How many Medication Lock Boxes would you like?

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