SMI - Health Systems Task Force

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Before submitting the form please confirm that the appropriate container is available and will be used for this pickup:

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Customer ID

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Customer ID

Please confirm that the appropriate container is available and will be used for this pickup, before submitting the form:*

Yes

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Logistic Service

Delivery

Pickup

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Business Type

WEEE

Batteries

Medical devices

Waste Stream*

Injectables

Inhalers

Injectables & Inhalers

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Quantity of boxes

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Total weight (in kg)

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Quantity (units) – Devices

Please enter a number from 1 to 99999.

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Item model

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Item Serial Number

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Purchase ID Number

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Container Type

Medical waste container

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Do you need proof of IT asset disposal?

Yes

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High Priority?

Yes

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Invoice Upload

Max. file size: 32 MB.

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Desired Date of Service

MM slash DD slash YYYY

Item – Additional information

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Item 2

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Logistic Service

Delivery

Pickup

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Business Type

WEEE

Batteries

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Waste Stream

Alkaline Batteries

Li-ion batteries

NiCd

NiMH

E-scooter Loose parts

Full Scooter without Battery

Lamps

Large Equipments

Monitors and Screens

Small Equipments

Small IT

Temperature Exchangers

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Quantity (units)

Please enter a number from 1 to 30.

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Total weight (in kg)

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Quantity (units) – Devices

Please enter a number from 1 to 99999.

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Item model

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Item Serial Number

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Purchase ID Number

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Container Model

200l drum

200l drum + vermiculite

10 m3 container

2 m3 container

20 m3 container

5 m3 container

600l ASP

600l ASP + vermiculite

Cardboard box

Euro Pallet

Paloxes

Paloxes + vermiculite

Vermiculite bags

None

60l drum

60l drum + vermiculite

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Do you need proof of IT asset disposal?

Yes

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Do you need packaging service?

Yes

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Invoice Upload

Max. file size: 32 MB.

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Desired Date of Service

MM slash DD slash YYYY

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High Priority?

Yes

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Item – Additional information

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Item 3

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Logistic Service

Delivery

Pickup

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Business Type

WEEE

Batteries

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Waste Stream

Alkaline Batteries

Li-ion batteries

NiCd

NiMH

E-scooter Loose parts

Full Scooter without Battery

Lamps

Large Equipments

Monitors and Screens

Small Equipments

Small IT

Temperature Exchangers

This field is hidden when viewing the form

Quantity (units)

Please enter a number from 1 to 30.

This field is hidden when viewing the form

Total weight (in kg)

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Quantity (units) – Devices

Please enter a number from 1 to 99999.

This field is hidden when viewing the form

Item model

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Item Serial Number

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Purchase ID Number

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Container Model

200l drum

200l drum + vermiculite

10 m3 container

2 m3 container

20 m3 container

5 m3 container

600l ASP

600l ASP + vermiculite

Cardboard box

Euro Pallet

Paloxes

Paloxes + vermiculite

Vermiculite bags

None

60l drum

60l drum + vermiculite

This field is hidden when viewing the form

Do you need proof of IT asset disposal?

Yes

This field is hidden when viewing the form

Do you need packaging service?

Yes

This field is hidden when viewing the form

Invoice Upload

Max. file size: 32 MB.

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Desired Date of Service

MM slash DD slash YYYY

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High Priority?

Yes

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Item – Additional information

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Item 4

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Logistic Service

Pickup

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Business Type

WEEE

Batteries

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Please confirm that the provided cardboard box is available and will be used for this pickup

Yes

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Waste Stream

Alkaline Batteries

Li-ion batteries

NiCd

NiMH

E-scooter Loose parts

Full Scooter without Battery

Lamps

Large Equipments

Monitors and Screens

Small Equipments

Small IT

Temperature Exchangers

This field is hidden when viewing the form

Quantity (units)

Please enter a number from 1 to 30.

This field is hidden when viewing the form

Total weight (in kg)

This field is hidden when viewing the form

Quantity (units) – Devices

Please enter a number from 1 to 99999.

This field is hidden when viewing the form

Item model

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Item Serial Number

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Purchase ID Number

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Container Model

200l drum

200l drum + vermiculite

10 m3 container

2 m3 container

20 m3 container

5 m3 container

600l ASP

600l ASP + vermiculite

Cardboard box

Euro Pallet

Paloxes

Paloxes + vermiculite

Vermiculite bags

None

60l drum

60l drum + vermiculite

This field is hidden when viewing the form

Do you need proof of IT asset disposal?

Yes

This field is hidden when viewing the form

Do you need packaging service?

Yes

This field is hidden when viewing the form

Invoice Upload

Max. file size: 32 MB.

This field is hidden when viewing the form

Desired Date of Service

MM slash DD slash YYYY

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High Priority?

Yes

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Item – Additional information

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Item 5

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Logistic Service

Delivery

Pickup

This field is hidden when viewing the form

Business Type

WEEE

Batteries

This field is hidden when viewing the form

Waste Stream

Alkaline Batteries

Li-ion batteries

NiCd

NiMH

E-scooter Loose parts

Full Scooter without Battery

Lamps

Large Equipments

Monitors and Screens

Small Equipments

Small IT

Temperature Exchangers

This field is hidden when viewing the form

Quantity (units)

Please enter a number from 1 to 30.

This field is hidden when viewing the form

Total weight (in kg)

This field is hidden when viewing the form

Quantity (units) – Devices

Please enter a number from 1 to 99999.

This field is hidden when viewing the form

Item model

This field is hidden when viewing the form

Item Serial Number

This field is hidden when viewing the form

Purchase ID Number

This field is hidden when viewing the form

Container Model

200l drum

200l drum + vermiculite

10 m3 container

2 m3 container

20 m3 container

5 m3 container

600l ASP

600l ASP + vermiculite

Cardboard box

Euro Pallet

Paloxes

Paloxes + vermiculite

Vermiculite bags

None

60l drum

60l drum + vermiculite

This field is hidden when viewing the form

Do you need proof of IT asset disposal?

Yes

This field is hidden when viewing the form

Do you need packaging service?

Yes

This field is hidden when viewing the form

Invoice Upload

Max. file size: 32 MB.

This field is hidden when viewing the form

Desired Date of Service

MM slash DD slash YYYY

This field is hidden when viewing the form

High Priority?

Yes

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Item – Additional information

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Instructions

1. Submit your request.

2. Request is validated by customer service. You will receive an e-mail with complete takeback.

3. Prepare the package.

4. Print and attach on the package the prepaid label received by email.

5. Bring your package to one of the drop-off points or arrange a pick-up.

1. Submit your request.

2. Request is validated by customer service. You will receive an e-mail with complete takeback.

3. Prepare the package.

4. Deliver the package to carrier that will show-up at the agreed day and time.

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I have read the Terms of Use.

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I have read the Privacy Policy.

Contact Details

Please select from the drop down menu your store:*

Contact Person Name*

Phone number*

Email*

Address

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Please select from the droop down menu your store:*

Street Address*

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Floor

Zip / Postal Code*

City*

Province

Country*

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Central pick-up point

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Openning Hours

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Type of Request

H2C Customer

End Customer

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Is the waste at the ground floor?

Yes

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Does the building has a lift?

Yes

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Is the collection site located farther than 50km from CDC?

Yes

Additional Details or Information

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Additional Details or Information2

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Additional Details or Information3

Review Submission

Country: {Country:73}
Category: {Waste Stream:116}
Collection Point: {Full Name:41}
Contact Person Name: {Contact person name:42}
Phone Number: {Phone number:179}
Email: {Email:172}
Store: {Store:41}
Address: {Street Address:69}, {City:72}, {Zip / Postal Code:71}

Submission Check*

I have double checked my entries for correctness

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Source

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Referral Parameters

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Referrer

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utm_id

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utm_source

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utm_medium

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utm_campaign

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utm_term

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utm_content

<img decoding="async" src="https://h2compliance.com/wp-content/uploads/2026/06/Background3.jpg" alt="Pharmaceutical Industry Take-Back"</h1>

Customer ID

Item 2

Item 3

Item 4

Item 5

Instructions

Contact Details

Address

Review Submission