RAPID BIN ADD NEW | Drugs and Alcohol

Date of collection
Date Format: DD slash MM slash YYYY
Staff Name*
DACT Team*
LGD (Council)*
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
RAPID Bin Locations
Prescription - Selected Items Only
Opiates (Codeine, Co Dydramol, Kapake, Tramadol / Maxitram, Oxycodone / Oxycontin, Dihydrocodeine)
Nerve/Anxiety (Lyrica / Pregabalin / Alzain), Gabapentin / Neurontin, Duloxetine)
Depressant / Anti-psychotic (Diazepam, Lorazepam, Seroquel / Quetiapine)
Codeine (Op)
Co Dydramol (Op)
Kapake (Op)
Tramadol/Maxitram (Op)
Oxycodone/Oxycontin (Op)
Dihydrocodeine (Op)
Lyrica / Pregabalin / Alzain (A.N)
Gabapentin/Neurontin (A.N)
Duloxetine (A.N)
Diazepam (D.AP)
Lorazepam (D.AP)
Seroquel/Quetiapine (D.AP)
Illegals
Drug Type
Alternative Description / Stamp / Logo
Qty NUMBER ONLY
Drug Type
Alternative Description / Stamp / Logo
Qty NUMBER ONLY
Drug Type
Alternative Description / Stamp / Logo
Qty NUMBER ONLY
Drug Type
Alternative Description / Stamp / Logo
Qty NUMBER ONLY
Other Prescription / OTC not already noted
All Other Items - Use the box below for one total for all other prescription or Over the Counter items.
Qty NUMBER ONLY
Photos Of Collection and Waste Transfer Note
Photo of Collection
Drop files here or
Take a photo of all of the drugs on a table. Lay drugs out in a flat lay and try to take the photo top down

Prescription - Selected Items Only