Report an incident



FSARR requires certified providers to notify FSARR as soon as possible, but no later than 72 hours after the incident.

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Company*

First Name*

Last Name*

Email*

Phone*

Address of Incident*

Certification Status*

Date of Incident*

Approx. Time of Incident*

:

Type of Incident*

Describe the Incident*

What actions were performed, i.e. CPR, Narcan, 911, Etc?*

What were this person’s “drug of choice”, if applicable?

Were there any pertinent behaviors prior to the incident or overdose that you can recall? What were those behaviors?*

If called, how soon were emergency responders called and how long did it take them to arrive?*

Was anyone notified other than emergency responders?*

What has been or will be done to assess and address the community in the aftermath?*

Gender of Client, if applicable

Male

Female

Non-Binary

Age

Delaware Resident?

Yes

No

Unknown

What State did they come from?

How long have they lived in DE?

Why did they come to DE?

Upload Supporting Documents

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NARR Standard 3.0

Plan for emergencies including intoxication, withdrawal, and overdose.



Verification that emergency numbers, procedures (including overdose and other emergency responses), and evacuation maps are posted in conspicuous locations.



Documentation that emergency contact information is collected from residents.



Documentation that residents are oriented to emergency procedures.



Report an incident

FSARR requires certified providers to notify FSARR as soon as possible, but no later than 72 hours after the incident.

NARR Standard 3.0

Verification that emergency numbers, procedures (including overdose and other emergency responses), and evacuation maps are posted in conspicuous locations.

Documentation that emergency contact information is collected from residents.

Documentation that residents are oriented to emergency procedures.

Verification that Naloxone is accessible at each location, and appropriate individuals are knowledgeable and trained in its use.

Get In Touch

Email

Get In Touch

Email

Jackson Carter

Sarah Simpkins

Grievance Line