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* 1. Do you have access to convenient disposal options for unwanted medications (meds) and used needles (sharps)?

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* 2. Where would you like to have access to a collection (disposal) program for unwanted meds and used sharps?

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* 3. Do you think meds and sharps manufacturers should share in the responsibility of providing convenient disposal options?

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* 4. Do you pledge to properly dispose of meds and sharps?

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* 5. Please tell us your story about what you have done to properly dispose of meds or sharps. Did you find it challenging or easy?

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* 6. Please provide us your residential zip code.

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* 7. Optional: Please provide your contact information including name and email.

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* 8. Optional: How did you find out about this pledge?

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