Request Supplies Use the form below to request complimentary transport supplies for your specimens. Supply Order Form Practice/physician name * Street Address * Address Line 2 City * State / Province / Region * ZIP / Postal Code * Contact Name * Contact phone * Contact Email Please provide your email address if you would like to receive email confirmation of your order. What would you like us to provide? Specimen Transport Bag 1 bag 2 bags Requisition forms 100 forms 200 forms 300 forms 400 forms 500 forms Specimen biohazard bags 1 package 2 packages 3 packages 4 packages 5 packages Packages of 100. Michel’s, 20 mL 5 vials 10 vials 15 vials Formalin, 20 mL 1 box 2 boxes 3 boxes 4 boxes 5 boxes 96 vials per box. Formalin, 40 mL 1 box 2 boxes 3 boxes 4 boxes 5 boxes 96 vials per box. Formalin, 60 mL 1 box 2 boxes 3 boxes 4 boxes 5 boxes 96 vials per box. Formalin, 90 mL 1 box 2 boxes 3 boxes 4 boxes 5 boxes 96 vials per box. Additional delivery instructions This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit Request Δ