Pick Up Request Form | Columbus
All pickup requests need to be submitted by 4pm, anything submitted past 4pm will be picked up the next day. Thank you!
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
Submit
Should be Empty: