The mission of KPhA is to advocate and advance the pharmacy profession to improve the health of Kentuckians.

KORE Data Reporting


Agencies that receive naloxone from the KORE grant are expected to collect and report some basic demographic information when they distribute the naloxone to their clients or in the community.

Agencies should submit reports at least ONCE per MONTH and ensure they are caught up on submissions before requesting more naloxone

If your agency is currently reporting naloxone distribution data via please continue to do so. If your agency has been consistently reporting via spreadsheet, there are some changes to the data that you may not yet be collecting.

Currently KORE requests that these data points be collected and reported with each naloxone given to individuals:

Date of Distribution
Zip Code of Residence
Race / Ethnicity
Age (Range)
Experience with naloxone
Product given
Quantity given

To assist with data collection and reporting, there are a variety of tools, both digital and physical that can be used.

Every agency that requests naloxone will need to register via . Once you click the link, you will be taken to a screen that looks like this:

After you submit and your registration is confirmed, you will receive a customized link via email for a digital data collection and reporting tool. This link will be unique to the user / email addressed used to register the agency. It will be multiuse and set to expire December 31, 2022. New links will be sent out at the beginning of January. The link to the tool can be bookmarked to the home screen on mobile devices where the icon looks like an app. 

Once you receive the custom link for your agency, you may share it within your agency to anyone that will be distributing naloxone and collecting data. However, if your agency has multiple locations that are reqeusting naloxone separately, do not share links between agencies, as this may result in inventory being inaccurately calculated. 

The form will look like this on your device:


There will be an option to email yourself a copy of the form after submission. 

If you prefer to use a physical, printed form to collect data from individuals, you can print the PDF linked on this page. The PDF has has two pages that can either be printed full sized, or two to a page cut apart and have smaller forms. 

If you opt to use the printable form, you can either use the ReadyOP link to submit your data or the Excel spreadsheet linked on this page. You will need to download the spreadsheet to fill it out then email it as an attachment to

If you have any questions at all about the data reporting requirements or tools, please contact Jody Jaggers at

Register Your Agency in ReadyOP

Follow the link below to register your agency in ReadyOP. Once registered, Agencies will receive a custom link to the online data reporting form. 

Templates and Printables

Excel Data Template Spreadsheet

Printable Data Collection Form