Fillable Application for Clinical Waste Collection (Aylesbury Vale District Council)

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Application for Clinical Waste Collection (Aylesbury Vale District Council)

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Last updated: 14 June 2018
1
Application for Clinical Waste Collection
Aylesbury Vale District Council offers a free weekly collection service for domestic
clinical waste.
To ensure this service is provided to those who require it, we conduct an annual
audit on all householders across the Vale registered to our clinical waste
collection service.
To remind you, there are three different types of clinical waste:
1. Sharps collection
Sharps including needles and syringes should never be put in normal rubbish bin, even if they
haven't been used. They should always be placed in a sharps box, which we will collect and
dispose of safely.
2. Waste that can be disposed in your green refuse bin
Non-hazardous waste such as nappies, incontinence pads and sanitary items do not require
specialist treatment or disposal and can be disposed of in your green refuse bin. We provide a
larger and/or additional green refuse bin free of charge to accommodate non hazardous/offensive
waste.
3. Waste that needs to be collected in orange sacks
Hazardous waste needs to be sent to be incinerated in order to prevent infection, this includes
items such as:
• Swabs and wound dressings/bandages,
• wound vacuum drains or pumps; and
• home dialysis waste (except empty saline or glucose IV bags which can be put in your
green refuse bin).
Please complete this form using BLOCK CAPITALS and return to the details at the top of the
accompanying letter:
Your details
Title:
First name:
Surname:
Address:
Email: address:
Telephone:
Last updated: 14 June 2018
2
Type of waste – to be completed by a healthcare professional
Must be completed by a healthcare professional (community nurse, practise nurse, consultant or
GP). Please indicate below the group of waste which are being produced by the resident.
Type of waste
Description
Tick as
appropriate
Sharps
Discarded or unused syringes and needles
Non-hazardous waste
Non-hazardous waste such as nappies, incontinence
pads and sanitary items
Hazardous waste
Waste that is deemed to be infectious or potentially
infectious and subjected to special treatment for
disposal such as infected wound dressings, stoma
bags
Any additional information
If changed from previous information provided OR any change of circumstances.
Name:
Signature:
Date:
Declaration – to be completed by a applicant
By my signature below, I certify the information I have provided on this form is true, accurate and
complete. I also understand that any false statements or deliberate omissions on the form could
result in the service being ceased.
Name:
Signature:
Date:
Please return this form to:
email: rwbusinesssupport@aylesburyvaledc.gov.uk
post :18 Pembroke Road, Aylesbury, Buckinghamshire, HP20 1DB
Last updated: 14 June 2018
3
Privacy Notice
Aylesbury Vale District Council (AVDC) is the controller for the personal information we use about
you. We are committed to protecting your privacy when you use our services. The law requires us
to give you a Privacy Notice which gives you details about how we use and protect your information.
Our contact details are:
The Gateway, Gatehouse Road, Aylesbury, Buckinghamshire, HP19 8FF. Telephone: 01296
585858
Our Data Protection Officer is Mr Andy Barton. He can be contacted on
jbinning@aylesburyvaledc.gov.uk or telephone 01296 585495.
What information do we have about you:
We can hold the following information:
• The address of the property on which you will like the clinical waste collection.
• The name and contact details of the person using the service.
• What type of clinical waste is generated at the household.
Why are we using your information?
We need your information so that we can:
• Provide a clinical waste collection which meets our customers needs.
• Administer the clinical waste collection.
• Contact you regarding the service.
We can use your information because:
• As your local authority we need it to collect waste as required by law.
We need to use special information relating to the clinical waste produced in your household which
may give health details (please see the Council’s main Privacy Notice for further information) and
we can use it because we need the information to collect waste as required by law.
If you do not give us your information it may affect how we make a decision on your clinical waste
application.
This information is only used for the reasons above but if we need to use it for any other reason we
will normally tell you.
We may share your information with
We may share information provided with other bodies responsible for auditing or administering
public funds, and in relation to safeguarding purposes or in connection with the prevention of crime,
criminal or legal investigations or proceedings including fraud (and the National Fraud Initiative) or
regulatory functions.
Automated Decision Making
We do not carry out any automated decision making.
Last updated: 14 June 2018
4
Your rights
You have legal rights over your information. For details of those rights, how long we keep your
information and how we keep it safe, see our main Privacy Notice page.
We would though like to bring to your attention that your information will be held for six years, from
the date on which this service is no longer required by you.
If you have any concerns and/or complaints you may write to Jackie Binning, Data Governance
Officer, on email jbinning@aylesburyvaledc.gov.uk
or telephone 01296 585495, or report on our
comments, compliments and complaints page.
If have any queries concerning your clinical waste collection, you may contact our Business Support
team on telephone 01296 585635 or you can email rwbusinesssupport@aylesburydc.gov.uk
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Application for Clinical Waste Collection (Aylesbury Vale District Council)

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Completed 29 October 2020

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