Customer Information Business Name Contact Name Address City State RI MA CT Zip Code E-mail Phone Fax How many service locations? Who is Your Current Transporter? Comments and/or Questions: Service Requirement: Number of service locations of company: Business Hours: Lunch Hours: Medical Waste Frequency Daily Weekly 2 Weeks 4 Weeks 6 Weeks 12 Weeks 2 Times/Year Current Box Size 1.3 CF 2.2 CF 4.5 CF ?? # of Boxes Each Pickup X-Ray Waste Service Needed Yes No Size of Container 2.5 Gallon 5 Gallon # of Containers Each Pickup You will receive a faxed proposal outlining our services along with a price quote. We will follow up with a phone call 24 to 48 hours later. We look forward to the opportunity to service your facility. Services | Programs | How to Package | Supplies | Schedule a Pick-Up Rules and Regulations | Get a Quote | About Us | Home
You will receive a faxed proposal outlining our services along with a price quote. We will follow up with a phone call 24 to 48 hours later. We look forward to the opportunity to service your facility.
