Connecticut Opioid Settlement Expenditure Report - FY26

Instructions: This form should be completed by all municipalities that received Connecticut Opioid Settlement Abatement funds during state fiscal year 2026 (July 1, 2025- June 30, 2026)

Each municipality must complete a separate form.

All opioid settlement funds received and spent during the covered period must be reported.

All submissions are due on or before October 1, 2026.

Question Title

1. Name of the municipality you are reporting on (Required.)

Contact Information

Question Title

2. Contact Information (Designated Municipal Administrator) (Required.)

Question Title

3. Primary contact email (Required.)

Question Title

4. Primary contact phone (Required.)

Question Title

5. Contact Information (Secondary Contact)

Question Title

6. Secondary contact email

Question Title

7. Secondary contact phone

Connecticut Opioid Settlement Expenditure Report - FY26

Question Title

* 1. Name of the municipality you are reporting on (Required.)

Question Title

* 2. Contact Information (Designated Municipal Administrator) (Required.)

Question Title

* 3. Primary contact email (Required.)

Question Title

* 4. Primary contact phone (Required.)

Question Title

* 5. Contact Information (Secondary Contact)

Question Title

* 6. Secondary contact email

Question Title

* 7. Secondary contact phone

1. Name of the municipality you are reporting on (Required.)

2. Contact Information (Designated Municipal Administrator) (Required.)

3. Primary contact email (Required.)

4. Primary contact phone (Required.)

5. Contact Information (Secondary Contact)

6. Secondary contact email

7. Secondary contact phone