NALOXONE DISTRIBUTION AGREEMENTNaloxone Distribution Agreement • May 17th, 2022 • Ontario
Legal Name of Community Organization: Click here to enter text. Type of Community Organization: ⃝ Community Health Centre ⃝ Aboriginal Health Access Centre ⃝ Outreach Organization ⃝ AIDS Service Organization ⃝ Shelter ⃝ Withdrawal Management ⃝ Other: Click here to enter text.(specify) Address: Street:Click here to enter text. City:Click here to enter text. Province: Ontario Country: Canada Postal Code:Click here to enter text. Designated Contact: Tel.: (###) ### - #### ext. ##### Fax: (###) ### - #### ext. ##### E-mail: Click here to enter text.
