EGLE HOUSEHOLD DRUG TAKE BACK MAP
SUBMISSION FORM

Please use this form to have a household drug collection location added or removed to the interactive map.


Please provide the following information (* required):

 

Collection Location Information

New Submission       Modification of Current Listing    Removal of Listing

* Collection Location Name:   
* Collection Street Address  
* City:   Zip:
* Substances accepted
 (check all that apply):

  Controlled Substances      Solid Medications       Liquid Medication       Sharps/Needles 

Notes (include details such as event date here):

 
* Program/Collection Location Phone Number:  
* Program/Collection Location Web Site:  

* Program/Collection Location Contact Email:

 

 

          


Michigan Department of Environment, Great Lakes, and Energy
800-662-9278 | Michigan.gov/EGLE
EGLE-DrugDisposal@Michigan.gov