Medication Bag Request Form
Residents of Pacific County, Washington are eligible to receive a FREE lockable medication bag for at-home safe storage of medications. Restricting access to medications helps to reduce the diversion and abuse of substances. 𝙏𝙝𝙚𝙨𝙚 𝙨𝙪𝙗𝙨𝙩𝙖𝙣𝙘𝙚𝙨 𝙞𝙣𝙘𝙡𝙪𝙙𝙚, 𝙗𝙪𝙩 𝙖𝙧𝙚 𝙣𝙤𝙩 𝙡𝙞𝙢𝙞𝙩𝙚𝙙 𝙩𝙤, 𝙥𝙧𝙚𝙨𝙘𝙧𝙞𝙥𝙩𝙞𝙤𝙣 𝙖𝙣𝙙 𝙤𝙫𝙚𝙧 𝙩𝙝𝙚 𝙘𝙤𝙪𝙣𝙩𝙚𝙧 𝙢𝙚𝙙𝙞𝙘𝙖𝙩𝙞𝙤𝙣, 𝙫𝙖𝙥𝙚 𝙥𝙧𝙤𝙙𝙪𝙘𝙩𝙨, 𝙢𝙖𝙧𝙞𝙟𝙪𝙖𝙣𝙖 𝙥𝙧𝙤𝙙𝙪𝙘𝙩𝙨, 𝙖𝙣𝙙 𝙢𝙤𝙧𝙚.

Through the collaboration of Teen Advocacy Coalition, Road 2 Resiliency, WellSpring Community Network, Pacific County Health and Human Services, and Willapa Behavioral Health, these safe storage tools are provided at no cost to community members.

To request a medication bag, please complete the form below. If you have questions or for more information, please contact Denise Rowlett at pacificcountytac@gmail.com or 360-984-4199.

𝘛𝘩𝘦 𝘱𝘦𝘳𝘴𝘰𝘯𝘢𝘭 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘺𝘰𝘶 𝘱𝘳𝘰𝘷𝘪𝘥𝘦 𝘪𝘴 𝘶𝘴𝘦𝘥 𝘴𝘰𝘭𝘦𝘭𝘺 𝘵𝘰 𝘳𝘦𝘴𝘱𝘰𝘯𝘥 𝘵𝘰 𝘺𝘰𝘶𝘳 𝘳𝘦𝘲𝘶𝘦𝘴𝘵. 𝘞𝘦 𝘸𝘪𝘭𝘭 𝘯𝘰𝘵 𝘷𝘰𝘭𝘶𝘯𝘵𝘢𝘳𝘪𝘭𝘺 𝘴𝘩𝘢𝘳𝘦 𝘪𝘵 𝘦𝘹𝘤𝘦𝘱𝘵 𝘸𝘩𝘦𝘳𝘦 𝘸𝘦 𝘢𝘳𝘦 𝘳𝘦𝘲𝘶𝘪𝘳𝘦𝘥 𝘵𝘰 𝘣𝘺 𝘭𝘢𝘸.
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Lockable Medication Bag - 10" x 8" with combination padlock
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