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Specimen Pick-Ups
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Business / Clinic Name?
*
Name of who submitted this form
*
First
Last
Call Back Number
*
If we are unable to locate the specimens for pickup.
What is the Address of the pickup?
*
When is your pickup ready?
*
Now - Ready in Lockbox
After 5 PM - In Lockbox
special your Any
Any special instructions for the courier?
Request Pickup
