The code block below illustrates how one might use # and // as comments in your logic and calculations.
# Text can be put here to explain what the logic/calculation does and why.
if ([field1] = '1' and [field2] > 7,
// This comment can explain what the next line does.
[score] * [factor],
// Return '0' if the condition is False.
0
)
Working...
0% means
50% means
100% means
This value you provided is not a number. Please try again.
This value you provided is not an integer. Please try again.
The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.
The value you provided must be within the suggested range
The value you provided is outside the suggested range
This value is admissible, but you may wish to double check it.
The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).
This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.
This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.
This field must be a valid email address (like joe@user.com). Please re-enter it now.
The value you provided could not be validated because it does not follow the expected format. Please try again.
This report is for anyone in Massachusetts who responded to an overdose firsthand or were present while someone else responded. Please do not use this form for your own overdose. If you survived an overdose, please ask the person who responded to fill out a form.
Your report will contribute to valuable data that can uncover trends, identify hotspots, and inspire new overdose prevention programs. Your actions directly impact the safety of our communities by shaping the decisions made by harm reduction programs, healthcare workers, and policy makers doing work related to the overdose crisis.
Please note: this form is entirely anonymous and confidential. This is a Massachusetts Department of Public Health reporting form, which will not ask for identifiable information about the responder or the person who overdosed. None of the questions on this form require a response if you do not wish to answer the question or do not know the answer to it. Fill out the form as best as you are comfortable and able to do. The more complete the form is, the more accurate our public health information will be.
If you have additional questions or would like to debrief the overdose you witnessed or responded to, you can reach out to naloxone@mass.gov. We appreciate your time and participation!
You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.
