Controlled Substance Disposal Request

Any person in possession of any controlled substance is required to follow appropriate disposal procedures. Complete the form below to request pick up by an approved and authorized representative from EH&S. The animal protocol number and copies of inventory utilization (if available) will be requested at the time of pick up. Please submit one request for each substance.

Requester Name*

Email*

Phone*

PI/Supervisor Name*

Department*

Location*

Research Protocol (if applicable)

Substance*

Number of Bottles/Vials*

Additional Information

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