Get Destruction Request Form

Filling out the Destruction Request Form correctly is essential for ensuring compliance with regulations regarding the disposal of controlled substances. This guide will provide you with clear, step-by-step instructions to help you successfully complete the form online.

Follow the steps to complete the Destruction Request Form online

1. Press the ‘Get Form’ button to obtain the Destruction Request Form and open it in your preferred online document editor.
2. Begin by entering your clinic's name in the designated field where it says 'Clinic Name.' Ensure that the information you provide is accurate and up to date.
3. Fill in the complete address of your clinic in the 'Address' section. Include any relevant details that specify your location.
4. In the 'Phone' field, provide a contact number where you can be reached. Alternatively, you may also enter your fax number in the 'Fax' field if applicable.
5. Enter your email address in the 'Email' field to ensure prompt communication regarding your request.
6. List the veterinarian's name and their corresponding license number in the respective fields. This information is necessary for verification purposes.
7. Sign and date the form in the provided sections. Your signature certifies the authenticity of the request.
8. In the section for product details, document the product name and concentration for each item you wish to destroy. Ensure clarity to avoid any confusion.
9. Record the lot number and expiry date for each product on the appropriate lines. This important information assists in the tracking and disposal process.
10. Once you have completed all sections of the form, you can save the changes, download a copy for your records, or print it for submission.

Complete your Destruction Request Form online today to ensure compliance and safe disposal.