MEDICAL WASTE SERVICES
PRODUCTS
COMPLIANCE SERVICES
Company Name
Contact Name
Title
Phone
Email
Service Address
City
State
Zipcode
Comment
Current Vendor
Service Frequency
Please Select OneWeeklyEvery 2 WeeksEvery 4 WeeksEvery 8 WeeksEvery 12 Weeks
Type of Medical Waste
BiohazardSharpsPharmaceuticalChemotherapyPathology
Size of Containers
Please Select One17 gallon31 gallon43 gallon95 gallon
Quantity of Containers
Please Select One123456789101112131415
Average Monthly Weight in Pounds
Current Monthly Costs
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