Self Medicating Waste Collection Request

Average response time

8,566.29 minutes

Local Authority

Issue Type

Full Name

Address Line 1

Address Line 2



Email Address

GP Name

Comments/Special requirement/Access instructions

You must tick the box to give us a permission to store the details that you have given us. The Data Protection Act 1998 requires us to ask you to do this so that we can ensure that the data you have given us is kept confidential and will not be shared with any unauthorised parties.