Wisconsin household pharmaceutical collection site registration (Form 4430-030) |
Household pharmaceutical collection program information
As of July 1, 2015, Wisconsin law requires persons who collect unused medications from households to register their collection sites with the Wisconsin Department of Natural Resources.
Items marked with an asterisk (*) are required.
NOTICE: This form is authorized by s. 165.65(5)(d), Wis. Stats. Completion of this form is required, except where stated on the form or in the instructions. Personally identifiable information will be used for program
administration and must be made available to requesters as required by Wisconsin Open Records law [s. 19.3119.39,
Wis. Stats].
administration and must be made available to requesters as required by Wisconsin Open Records law [s. 19.3119.39,
Wis. Stats].