The state of Arizona has a program for first responders to report any out-of-hospital suspected opioid overdoses, suspected opioid overdose deaths, and out-of-hospital use of naloxone to treat opioid overdose. The state asks first responders to report the information through the web-based Arizona Prehospital Information and EMS Registry System (AZ-PIERS), but this paper form is available if the AZ-PIERS system cannot be accessed.
Funding Source: Arizona Department of Health Services
Prehospital Opioid Overdose Reporting Tool
Form for Arizona first responders to report out-of-hospital overdose incidents