MEDICAL WASTE SERVICES
PRODUCTS
COMPLIANCE SERVICES
Company Name
Contact Name
Title
Phone
Email
Service Address
City
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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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