Destruction and Disposal Log Collection Receptacle

Form Template

Completion of this app meets the notification requirements under the public health code under the program for utilization of unused prescription drugs for participating pharmacies and charitable clinics to record each time the contents of a collection receptacle containing donated prescription drugs not eligible for dispensing are removed for destruction and disposal.

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Copies of all contracts with reverse distributors for off-site destruction and disposal must be stored with this Destruction and Disposal Log. This app can also be used for the destruction and disposal of other hazardous waste and toxic materials such as mercury, fluorescent light bulbs, thermostats, and nitric acid. The Destruction and Disposal Log Collection Receptacle mobile app allow you to replace your paper log with a smartphone, tablet or computer. The mobile form includes fields to document items such as participating pharmacy or charitable clinic, license or registration number, phone, the weight of contents and method of destruction/disposal. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your chemical clean up records. You can also use the App Builder to personalize and customize this mobile form.

Features
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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