Safe Medication Disposal Program:          Providing Deterra Pouches and Mail-In Envelopes

OPEN aims to remove the risk of unused medications and substances from our community by offering medication disposal options that are convenient for everyone.  

We are pleased to offer an opportunity for organizations to apply for medication deactivation pouches (disposal) and medication mail-in envelopes (disposal) in order to provide safe medication disposal options to patients and their families. 

If you are interested in providing these resources to your patients or community, please carefully review the program description and complete the form below.   

Applications are reviewed on a rolling basis and selected applicants will be contacted by email. 
Please review the Deterra Pouches and Mail-In Envelopes Disposal Program page for detailed information.

Please contact us with questions at OPEN-support@med.umich.edu. 
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Primary Contact Information: Name, title, email
Organization Name 
Organization Location
Organization Description
What patient populations and general services are provided by your organization? 
Describe how patients will be selected to receive these medication disposal products.
What is the estimated annual volume of selected patients served?
Would you like safe storage and disposal education resources to share along with the products?
How many cases of Deterra Medication Disposal Pouches are you requesting? 
(Note: Disposal pouches must be ordered by case and each case contains 200 pouches.) 
How many cases of Medication Mail-in Envelopes are you requesting? 
(Note: Mail-in envelopes must be ordered by case and each case contains 250 envelopes.) 
Any other relevant information you would like to share 
Up to 100 word response per question
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