Schedule a Pickup We come to you. Input your zipcode below. Zip Code Search(Required) Your location currently falls outside of our driver's service area. Please email us at firstname.lastname@example.org for additional assistance.HiddenSection BreakYour location is within our service area. Please complete the following form to ensure all pertinent details are submitted when placing this request.Clinic Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Clinic Name(Required) Contact Name(Required) First Last PhoneEmail Requested Date(Required) MM slash DD slash YYYY Requested Time Range of PickupChoose Your Time9am-12pm12pm-3pm3pm-7pmLocation of Specimen(Required) Quantity of Specimen(Required) Select Specimen Type(s) Check all that Apply(Required) Blood Urine Stool Other Select Specimen Temperature(s) Check all that Apply(Required) Refrigerated Room Temperature Dry Ice Frozen Do you currently have a lock box? *(Required) Yes No If yes, please provide specific details below of where the box is located:Enter any additional details about the pickup below.