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Report an Overdose Reversal

You are a hero! Congratulations on saving a life. You have made a significant, positive impact in your community simply by choosing to always carry naloxone and having been trained on its proper use. By being prepared and willing to help in an overdose crisis, not only the person you saved but their friends, family, co-workers and many others are undoubtably grateful for your heroic response. We certainly are!


We would like to hear about your recent experience saving a life with one of Max's Mission's naloxone kits. Please fill out the form below. The process only takes a few minutes and you may remain completely anonymous, if you prefer. The information you contribute helps Max's Mission better understand the nature of overdose in Southern Oregon, Each opioid recovery story provides vital, real-time data that guides our research efforts, helps secure continued funding for no-cost naloxone distribution, and ultimately supports the goal of preventing the needless tragedy of death caused by opioid overdose. No personal information is required - just your honest input

(Optional)

(Optional)

Where did you get your naloxone kit(s)?

(Optional)

When did the overdose happen?
Month
Day
Year
Did you administer the Naloxone?
Yes
No
What type of Naloxone was used? (select all that apply)
Were rescue breaths given to the person overdosing?
Yes
No
Did the person overdosing regain consciousness?
Yes
No
Were emergency services called?
Yes
No
Did the person overdosing go to the hospital?
Yes
No

E.g., reversal story, suspected substance(s) involved in overdose, reaction from person overdosing after receiving Naloxone.

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1117 East Main Street Suite 3, Medford | 541-499-8485

P.O. Box 1145, Jacksonville | 458-225-9760

720 Rogue River Hwy, Grants Pass | 541-499-8108

3815 S. 6th Street Ste 200, Klamath Falls | 541-499-8012

Klamath Jobs for You - Max's Mission supported employment center

3255 Washburn Way Ste 5, Klamath Falls, OR | 458-302-1604

Max's Mission © 2025

Max's Mission is designated as a 501(c)(3) - 990 Tax Form

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