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Application for the Helping Emergency Responders Obtain Support (HEROS) Program (2nd Round)

In response to the nationwide opioid epidemic, funding has been made available through the Florida Department of Health (DOH) for emergency opioid antagonists. The DOH has been appropriated $5,000,000 from the General Revenue Fund for the purchase of emergency opioid antagonists to be made available to emergency responders. DOH has established the HEROS Program for the purpose of acquiring emergency opioid antagonists for agencies that employ emergency responders.

Federal Employee Identification Number



Agency Information





Agency Head





Agency Contact Information for HEROS Program





Shipping Address






Application Information







Please indicate the total number of doses and for each type of Naloxone being requested












Narrative


OATH: "Under penalties of perjury, by submission to the Florida Department of Health, I declare that I have read the foregoing application and that the facts stated in it are true." I understand that all I attest to in this application is subject to audit by the Department.