Fill out the Collection Supply Request Form below. A copy will be automatically sent to Qitek Labs. Collection Supply Request Account InformationAccount Name* Contact Name* Phone* Email* Address* City* State* Zip Code* ShippingBiohazard Specimen Transport Bags (25 per Case)# of Cases NeededUPS Laboratory Pak Bags (10 per Case)# of Cases NeededBarcode Labels (300 Labels, 1 per Case)# of Cases Needed **Note: This item can only be ordered if Qitek Labs supplied a barcode label printer.Barcode Label Printer (1 per Case)# of Cases Needed **Note: This item is only provided by Qitek Labs under special conditions. Georgia Return Labels# of Georgia Return LabelsOklahoma Return Labels# of Oklahoma Return LabelsPPE (Only for Qitek Collectors)Small Gloves# of Boxes NeededMedium Gloves# of Boxes NeededLarge Gloves# of Boxes NeededExtra Large Gloves# of Boxes NeededDisinfecting Wipes# of Containers NeededHand Sanitizer# of Bottles NeededToxicologyUrine Cups (25 per Case)# of Cases NeededYellow Top Vacutainers (Tox, 25 per Case)# of Cases NeededPharmacogenomicsBuccal Swabs (25 per Case)# of Cases NeededMolecular Microbiology (RPP, Ear, UTI, Wound)Nasopharyngeal Swabs (RPP, 10 per Case)# of Cases NeededEar Swabs (Ear, 10 per Case)# of Cases NeededUrine Cups (25 per Case)# of Cases NeededGray Top Vacutainers (UTI, 25 per Case)# of Cases NeededWound Swabs (Wound, 10 per Case)# of Cases NeededNotificationsName 1 and Name 2 listed below will be notified with shipment information.Name 1 Email 1 Name 2 Email 2 Δ
