Lab and Animal Research Controlled Substances Disposal Form

UC Irvine Laboratory and Animal Research Controlled Substances
Disposal Request

Any person in possession of any controlled substance is required to follow appropriate disposal procedures. Complete the form below to request a 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.

Disposal Information:
*required fields

*Name: (first) (last)

*Phone:

*Principal Investigator or Supervisor: (first) (last)

*Department:

*Building (Pick up location for unit):

*Room (Pick up location for unit):

E-Mail:

Item Information:
Research Protocol number (if applicable):

Drug Information (if applicable) (e.g., type, quantity ):

Additional Information:

PRINT a copy for your records BEFORE clicking the “Next” button.