Thurrock Council

Application for Clinical Waste Collection

Strictly confidential

How we will use your information

We will use your information to provide the service requested. We may share your personal data between our services and with partner organisations, such as government bodies and the police. We will do so when it is of benefit to you, or required by law, or to prevent or detect fraud. To find out more, go to thurrock.gov.uk/privacy. Get free internet access at libraries and community hubs.

Your details

Name:
Address:
Postcode:
Phone:
Email:

Types of waste

To be completed by a community nurse, practise nurse, consultant or GP – please indicate below the groups of waste that, in your professional opinion, are being produced:

Type of waste / Description / Applicable?
Sharps / Discarded syringes and needles – in a yellow-lidded sharps container. / Yes No
Offensive waste / Non-infectious incontinence pads, bed pan liners, stoma bags, etc. – in yellow sacks with black stripe. / Yes No
Infectious waste / Waste that is deemed to be infectious or potentially infectious and subject to special treatment for disposal, such as infected wound dressings – in orange sacks. / Yes No
Do we need to be aware of specific risks associated with the waste? / Yes No

Community nurse, practise nurse, consultant or GP approval

Name: / Official
NHS
Stamp
Signature:
Date:

About the disposal of clinical waste

Clinical waste includes:

·  infectious items

·  identifiable human tissue

Please go to thurrock.gov.uk/sharps to check:

·  items that are not considered clinical waste and should be disposed of as ordinary domestic non-recyclable waste in a grey/green wheeled bin, the same as used disposable nappies and sanitary products

·  the addresses of local pharmacies where clinical sharps – needles, syringes, lancets or needle clippers – can be deposited for free in boxes we provide

Filled sacks are usually collected each week from outside your front door, with new empty sacks being posted through your letterbox or left in a nearby visible place.

If either this is not convenient, or needles from syringes cannot be taken to the pharmacies listed at thurrock.gov.uk/sharps – for example, where transport is not available – please state where we can collect filled sacks and where new empty sacks can be left:

Is the waste generated by a health care professional in the resident's home?

Yes – this waste should be disposed of by the health care professional
No – this waste may be disposed of by Thurrock Council

To return this form, please either:

·  post to: Trade Waste Team
Thurrock Council
Oliver Close Depot
Oliver Road
West Thurrock
RM20 3ED

·  email to

Please do not return this form in person as Oliver Close Depot is an active operational site with large vehicles frequently moving around.

For office use only
Date received: / By: / Approved: / Yes No

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