DisposeRx Packets:
Request for Purchase

Thank you for your interest in purchasing our DisposeRx at-home, abuse-deterrent. Solution. DisposeRx is committed to the eradication of unused medications.

Please complete the requested information below and a DisposeRx representative will contact to you in the near future. You may also call us at +1 (844) 456-1600.

* Please enter missing information in highlighted fields.

Contact Information

Organization Address

Organization Ship-To Address

Number of Packets Requested

Max words: 500
BRIEF DESCRIPTION

In 500 words or less, please describe your organization and the program for which you are requesting donated DisposeRx Packets.

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you in the near future.

Please also consider following us on Facebook, Twitter, LinkedIn and Instagram.

DisposeRx Packets:
Donation Application Form

DisposeRx is committed to the eradication of unused medications. As announced at the White House signing ceremony for the historic opioid legislation package known as HR-6, DisposeRx will be working with charitable organizations, faith—based groups and foundations to donate enough of our abuse—deterrent packets to destroy 10 million opioid tablets in home medicine cabinets across the nation.

If you represent a 501(c)3 organization, association, faith—based group or foundation and are interested in applying for a donation of DisposeRx packets, please complete and submit the following form. A DisposeRx representative will reach out to you in the near future.

Please include, based on the number of people you plan to reach, how many packets you are requesting, the project purpose and scope, and benefit to your community. Projects that will yield measurable program metrics and methods of quantifying success are preferred.

Note: The name of your organization may be used in DisposeRx marketing materials if you receive donated product.

* Please enter missing information in highlighted fields.

Contact Information

Website and Social Media Handles (where applicable)

Organization Address

Organization Ship-To Address

Number of Packets Requested

Max words: 500
BRIEF DESCRIPTION

In 500 words or less, please describe your organization and the program for which you are requesting donated DisposeRx Packets.

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you in the near future.

Please also consider following us on Facebook, Twitter, LinkedIn and Instagram.

Contact
DisposeRx

* Please enter missing information in highlighted fields.

Contact Information

Organization Address

Organization Ship-To Address

Max words: 500
BRIEF DESCRIPTION

In general, what information would be most helpful to you?

Submit

Thank You

Thank you for your interest in DisposeRx. We will follow up with you in the near future.

Please also consider following us on Facebook, Twitter, LinkedIn and Instagram.

Instructions for Disposal

Disposal in Original Vial

Recommended Packet Guidance for Disposal in Original Vial

# OF
PACKETS
VIAL SIZE
ML DRAM
1
29.6 8
1
40.7 11
1
48.1 13
1
59.1 16
1
73.9 20
1
110.9 30
2
147.9 40
2
184.8 50
2
221.8 60

*The efficacy of DisposeRx's activated gel is not changed by changing the viscosity of the gel. The volume of water does not have to be exact when activating DisposeRx and may be greater or lesser than the recommended amount.

**Pill count is not a limiting factor for drug disposal, when using DisposeRx. DisposeRx's innovative technology is designed for at-home maintenance drug disposal and based on the size of the container not the pill count. This is due to the variation of vial and pill sizes and shapes.

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DisposeRx Inc.

503 Carthage Street, Suite 202

Sanford, NC 27330

+1 (844) 456-1600

Copyright 2017-2021 © DisposeRx Inc. All rights reserved.