Pick Up Request Form | Columbus
Starting Nov 3, 2025, Industry Lab is moving to the UPS Placard Program for faster, more reliable healthcare sample pickups. Form Questions? Contact your sales rep, call 513-866-7922, email upspickup@ildp.com, or fill out this link: https://form.jotform.com/252655753787069
Facility Name
*
Number of Specimens Ready for Pickup
*
Type of Specimen
Patient Initials
*
Where To Collect?
Your Name
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Facility Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Request
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: