Stop the Bleed Kit Distribution Register

Thank you for taking the time to distribute Stop the Bleed Kits throughout your zones. Please provide the distribution details for the agency receiving the materials. 

Before you begin please note:
  • This register is comprised of 15 questions and will take approximately 5 minutes to complete.
  • Clicking "Next" or "Back" will record your responses for a given page.
  • This survey will need to be completed in one sitting and for each recipient of the items.
Please click "Next" to start the survey.