Rx DESTROYER™ Order Form

Rx DESTROYER™ offers hospitals, clinics and surgery centers an environmentally safe means of disposing of unused or expired drugs that conforms to the DEA's latest standards of drug disposal and destruction. Because Rx DESTROYER™ is completely portable it can be easily stored in close proximity to the drugs themselves, making it the perfect tool to mitigate drug diversion.

Order Form

* required field

Name of the person placing order
Email Address
Contact Telephone #
Purchase Order Number
GPO Membership (if applicable)
Shipping Method
Tax Status
If you are Tax Exempt please email a copy of your exempt certificate to customerservice@gfmd.com.
Shipping Address
Healthcare Institution / Company
City / State / Zip
/ /
Billing Address (if different)
Healthcare Institution / Company
City / State / Zip
/ /
Please enter the quantity for each item that you wish to order.
Order QtyCatalog NumberUMqty/caseDescription
All Purpose Products
RX30each1Rx DESTROYER™ 30 gallon
RX5.0each1Rx DESTROYER™ 5.0 gallon
RX2.5case2Rx DESTROYER™ 2.5 gallon
RX1.0PROcase4Rx DESTROYER™ 1.0 Pro gallon
RX64case4Rx DESTROYER™ 1/2 gallon
RX16case12Rx DESTROYER™ 16 ounce
RX4case24Rx DESTROYER™ 4 ounce
For Liquids Products
RX5.0LIQeach1Rx DESTROYER™ 5.0 gallon w/hardener
RX2.5LIQcase2Rx DESTROYER™ 2.5 gallon w/hardener
RX1.0PROLIQcase4Rx DESTROYER™ 1.0 Pro gallon w/hardener
RX64LIQcase4Rx DESTROYER™ 1/2 gallon w/hardener
RX64HARDcase4Hardener Packets (hardens 4 bottles)
RX1.0HARDcase8Hardener Packets (hardens 4 bottles)
RX2.5HARDcase10Hardener Packets (hardens 2 bottles)
RX5.0HARDcase10Hardener Packets (hardens 1 container)
RXFUNeach1Universal Funnel
RXFUN32each132 OZ. Deluxe Transparent Funnel W/Lid
RX2.5 WALL each1Wallmount 2.5 gallon
RX2.5W/SEC each1Wallmount 2.5 gallon w/secure
RX2.5W/SECLeach1Wallmount 2.5 gallon w/secure & lock
RX1.0WALLeach1Wallmount 1 gallon
RX1.0W/SEC each1Wallmount 1 gallon w/secure
RX1.0W/SECLeach1Wallmount 1 gallon w/secure & lock
RX64 WALL each1Wallmount 64 oz
RX64W/SEC each1Wallmount 64 oz w/secure
RX64W/SECLeach1Wallmount 64 oz w/secure & lock
RXCABeach1Rx DESTROYER™ Security Cable (cable only)
RX16WALLeach1Wallmount 16 oz
RX1.0LCKBXeach1Rx DESTROYER™ LockBox 1 gallon
RX64LCKBXeach1Rx DESTROYER™ LockBox 64oz
DDA0001each1GFMD Wallmount
DDA0002each1Lock option with cable
RXCAPScase12Rx DESTROYER™ Vented Caps (fits 16oz, 64oz, & 1.0 gallon bottles)
RX2.5CAPScase6Rx DESTROYER™ 2.5 Gallon Bottle Vented Caps
400-PReach1Tap A Drop 0.5 fl oz
RXDOLLYeach1Rx DESTROYER™ Dolly for the 5 gallon container
Mail Back Program *
RX2.5MBeach1Rx DESTROYER™ 2.5 gal. Case Mail Back
RX1.0MBeach1Rx DESTROYER™ 1.0 gal. Case Mail Back
RX64MBeach1Rx DESTROYER™ 1/2 gal. Case Mail Back

*This Mail Back Program is PROHIBITED for use in the following states: Arkansas, California, Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Pennsylvania, Rhode Island, Vermont and Virginia.