Make a Commitment

First Name^* Required

Last Name^* Required

Email Address^* Required

Phone Number^* Required

Affiliation / Organization / Tribe^* Required

County^* Required

State^* Required–select an item–AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasU.S. Virgin IslandsUnited States Minor Outlying IslandsUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Select all that apply.

Please share details about your commitment.^* Required

For example, how many employees/customers/clients/students will you train? How many first aid kits will have these medications? How many medication units will you provide to employees/customers/clients/students?

By participating in the White House Challenge to the Save Lives from Overdose you grant the U.S. government permission to share the details of your organization’s or business’ commitment, which may be included in public-facing content related to the Challenge intended for access by the general public, without restrictions. This permission grants the U.S. Government a license to use, display, publish, broadcast, transmit, post, or otherwise disseminate information about your commitment.