Hazmat Shipping Request Form

Shipper's Information
Recipient's Information
If the material is from a human or animal source, reference any technical names, strains, etc. If the material is a chemical, reference any chemical names and percent of solution.
You must provide your own.
Note - must use the accurate weight of dry ice that will be used at the time of the shipment
Contents of Package
The samples and dry ice should be in the box, but do not seal the box. Remove any old labels that are not associated with this shipment. Please give 24hr advance notice to allow for scheduling. We will make every effort to accommodate same-day requests, but you must understand there may be prior requests being processed and there will be no guarantee your shipment can go out on short notice. EHS will complete the shipping papers, provide proper labels, and arrange for pickup of the package. EHS can provide UN-approved packaging, when required.