Schedule A Pickup Of Your Medical Waste

*Indicates a required field

*Doctor/Facility Name
*Street Address
Suite/Floor
*City
State		*Zip
*E-Mail
*Phone
Fax
CMW Customer #
*Office Hours		Example: M-F 8am-5pm, closed for lunch 12-1pm
*Contact Person
Alternate Contact Person

(Red Bag Waste)

Sharps containers, cultures and stocks, blood and blood-borne pathogen waste.

		Qty.
Minimum Pickup
5 Gallon Container (14x12)
10 Gallon Container (15.5x17)
20 Gallon Container (23x19)
32 Gallon Container (27x22)
48 Gallon Container (28.75x23.5)

(Yellow Bag Waste)

Trace chemotherapy waste, pathological waste and biological waste.

		Qty.
Minimum Pickup up to 5 Gallon Container
8 Gallon Container (17.5Hx15.5Wx11D)
20 Gallon Container (23x19)
32 Gallon Container (27x22)

(Incineration Waste)

Expired medications, and non-hazardous pharmaceutical waste.

		Qty.
Minimum Pickup
3 Gallon Container (16Hx13.5Wx6D)
8 Gallon Container (17.5Hx15.5Wx11D)

Do you require any supplies?

If so, please complete the section below.

		Qty.
5 Quart Sharps Container (12.5Hx5.5Wx10.75D)
2 Gallon Sharps Container (10Hx10.5Wx7.25D)
5 Gallon Container (14x12)
20 Gallon Container (23x19)
32 Gallon Container (27x22)
48 Gallon Container (28.75x23.5)
20 Gallon Incineration Container (23x19)
32 Gallon Incineration Container (27x22)
3 Gallon Pharmaceutical Container (16Hx13.5Wx6D)
8 Gallon Pharmaceutical Container (17.5Hx15.5Wx11D)
Biohazard Liners Red (Small - 5 Gallons)
Biohazard Liners Red (Medium - 20 Gallons)
Biohazard Liners Red (Large - 32 to 48 Gallons)
Biohazard Sign (8.5x11)
Biohazard Labels (2x3 in. & 3.5x5 in.)

We proudly carry Tyco Kendall sharps containers. If you don't see the type or size of container or sharps container you're currently using, please indicate the manufacturer and order number under Notes/Special Instructions, and we'll try to get it for you.

Notes/Special Instructions:

Type verification image: