Ordering Supplies

Please complete the form below to order any materials you may need.

*Note: Any order placed after 1:00 PM PST will be fulfilled on the next business day. Delivery may take up to 2 business days depending on method of transport. We apologize for any inconvenience this may cause, and we thank you for your patience and understanding.

Should you have any questions, are looking for an item not listed below, or if you have an urgent supply request, please contact Client Services at 415-353-7270.

    First time ordering supplies or using our service
    Provider Contact

    Provider Name *

    Degree *

    Attn

    Office Address *

    Have you moved

    Email

    Phone *

    (###) ### ####

    Fax

    (###) ### ####

    Oral Pathology Kits

    PLEASE USE THE PROVIDED FIELD TO INDICATE THE QUANTITY NEEDED.


    Number of Oral Kits

    [Each] For Oral Surgeons, DDS, etc. Each Oral Pathology Kit includes:

    • 1 Requisition Form & Oral Diagram
    • 1 Med 20ml Specimen Container
    • 1 Biohazard Specimen Bag
    • 1 FedEx Clinical Pak & Canister
    • 1 FedEx Pre-Printed Airbill


    Biopsy Supplies

    Please use the provided field to indicate the quantity needed.


    UCSF Requisition Forms

    [each]

    EMA Interface Requisition Forms

    [pack, 250 = 1 pack]

    Physician Address Labels for UCSF Requisition Forms

    [sheet, 30 = 1 sheet]

    *Please note that if you have multiple providers referring from your location, please list them in the "Other:" field at the bottom of this page.

    Small Specimen Container

    (7mL) [each]

    *Please note that we are currently unable to ship 7ml Specimen Containers outside of California. Please select either 20ml Containers or call us at 415-353-7270. Thank you.

    Medium Specimen Container

    (20mL) [each]

    Large Specimen Container

    (60mL) [each]

    XLarge Specimen Container

    (120mL) [each]

    XXLarge Specimen Container

    (480mL) [each]

    Immunofluorescence Bottles

    (DIF) [each, limit 10] Due to the shorter t1⁄2 of Michel's Transport Medium, we are limiting orders to ≤10 vials per order. Should you require >10 vials, please contact Client Services at 415-353-7270.

    Shipping Supplies

    Biohazard Specimen Bags

    [each]

    White Fold Up Shipping Boxes

    [each]

    FedEx Clinical Shipping Paks

    [each]

    FedEx Pre Printed Airbills

    [each]


    Other

    Please indicate below

    (Ie. "# Cardboard canisters for Oral Cases"; Physician Label Address Changes; Additional supplies not included above; Notes to our supply team, etc.)