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CDPH Naloxone Grant Program Letter of Interest

California Department of Public Health
Safe and Active Communities Branch
Naloxone Grant Program

REQUEST FOR APPLICATIONS (RFA #16-10967):
Naloxone Distribution Projects

LETTER OF INTEREST

Applicants must submit a Letter of Interest in order to apply for a grant through the Naloxone Grant Program. However, the letter is non-binding if the applicant later chooses not to apply. Please submit questions to ngp@cdph.ca.gov.

Please provide the following information:

1. Local Health Department (LHD) *This question is required.

2. Health Officer *This question is required.

Name
Phone Number
E-mail Address

3. Contact Person *This question is required.

Name
Phone Number
E-mail Address

4. Does your LHD intend to apply for a grant from the Naloxone Grant Program? *This question is required.

5. Do you intend to request the amount of funding allocated to cover administrative costs? *This question is required.

5. The deadline for submitting a grant application for the Naloxone Grant Program is May 1, 2017. Do you anticipate any challenges meeting this deadline? *This question is required.

5. If YES or UNSURE, please explain: *This question is required.

5. Do you anticipate any challenges to implementing the required grant activities? *This question is required.

5. If YES or UNSURE, please explain: *This question is required.

5. If your LHD does not intend to apply for a grant from the Naloxone Grant Program, or is unsure, please explain: *This question is required.