Fill out the Schedule a Pickup Request Form below. A copy will be automatically sent to Qitek Labs. Schedule a Pickup Clinic Name* Address (Street, City, State, Zip)* Date of Pickup* MM slash DD slash YYYY Earliest Pickup Time* : Hours Minutes AM PM AM/PM Latest Pickup Time (ALLOW 2 HOUR RANGE FROM EARLIEST PICKUP TIME)* : Hours Minutes AM PM AM/PM Where will the Package be Located? (i.e. Inside at Reception, Outside Front Door, In Specimen Drop Box, Outside Back Door)* Δ
