Overview

Complete this form to request disposal of prescription drugs and/or other medications from Safety Services.

Requests will be received by the Safety office in your region.

Department of Transportation (DOT) Regulations

DOT regulations (49CFR 173.197) require that all packages of regulated medical waste be prepared for transport in containers meeting the following requirements:

  1. Rigid
  2. Leak resistant
  3. Impervious to moisture
  4. Of sufficient strength to prevent tearing or bursting under normal conditions of use and handling
  5. Sealed to prevent leakage during transport
  6. Puncture resistant for sharps

NOTE: Special containers are required for liquid waste disposal. Call Safety Services to learn what container is required.

This form is intended for use regarding official TTUHSC clinic prescription drug/medication disposal only.

Important: The information entered must be accurate.

If you have any questions, please contact the Safety Services office:
Amarillo: (806)354-5441
Abilene: (432)335-1820
Dallas: (806)743-2597
El Paso: (915)783-5245
Lubbock: (806)743-2597
Odessa: (432)335-1820

Please Enter the Following Information

Today's Date and Time: Wednesday, July 23, 2014 1:00 AM

Requestor Information

  First Name
  Last Name
  Contact Email Address
  Phone Number
  Region
  Department
  Room #
  Account # (FOP)
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Click Substance Classification
(All That Apply):

Simply click on the classification of substances you have, and fill in the combined weight of all substances of that class.

For Example: If you have 3 liquid class drugs, click "Liquid" and enter the combined weight of all 3 drugs, if known.

Liquid

Solid

Hazardous

Controlled Substance Medication

Comments