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Environmental Health & Safety

 

Notification of Receipt of Prescription Drugs or Veterinary Supplies

Marked fields are required.

Principal Investigator Name:

Lab Location:

Building:
Room:
Signed for by (lab worker):
Date Received:
Received from:
Vendor:

Received Drugs/Supplies

No. of UnitsQty/Pkg SizeName of Item
Shipping Paperwork/Invoices
Be advised that you will need to send EH&S any shipping paperwork and/or invocies related to this receipt.
Name of Individual Completing this Form:
Email:
Comments:

By submission of this form, you acknowledge that prescription drugs will not be transferred, sold, traded, or shared.