Canada Wide Sharps Disposal Program - Pharmaceutical Waste Disposal

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PICK UP REQUEST

Once you have filled all of the containers we have provided you please package them in accordance to the requirements set out your service agreement and in absolute compliance to the specifications identified.

Requests must be received through the ONLINE PICK UP REQUEST FORM below or by Fax at 705 725.8819 Download a Copy of our Fax-in Request Form CLICK HERE

For your convenience E.C.S. will be posting additional resources including an instructional video on How to Package your Sharps Containers Safely below in the near future so please check back! (Posted Sept 22,2010)

ONLINE PICK UP REQUEST

Business Name:

Address:

City:

Phone Number:

Email:

Number of Packages:

Please Verify the Following Safe Packaging Measures are Completed

	I am using the ECS provided box and it is set up properly and is not damaged.
	I have lined the box with the yellow bag, there is nothing between the yellow bag and the box.
	I have ensured all containers are tightly sealed / locked and have placed them into the yellow bag.
	I verify that ABSOLUTELY ALL SHARPS in inside of the sealed sharps containers and there are NO sharps loosely placed into the box.
	I have tightly tied the yellow bag closed.
	I have sealed the shipping box with shipping tape and am confident it can not break.
	I have placed the shipping labels on the box.

REORDER INFORMATION

Yes, please reorder my last package

Please contact me to change my ordering details

Special Notes
(not required) :

PICK UP AUTHORIZED BY: