Hazmat Shipping Request Form

Shipper's Information
Building Address
FedEx Account Information
Recipient's Information
Shipping Address
Is this an international shipment?
Has the shipment been approved by the Export Control Office?
Does This Shipment Involve Materials That Would Require A Materials Transfer Agreement (MTA)?
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.
Do the contents contain any pathogens, viruses, or anything harmful to humans or animals?
Are the samples preserved?
Is dry ice being used?
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
Shipment requests will be evaluated within two working days of form submission, and a timeline for shipping will be provided according to the complexity of the shipment. Please allow at least one week of advance notice for international shipments. EHS will complete the shipping papers, provide proper labels, and arrange for pickup of the package. EHS can provide UN-approved packaging, when required. If shipping samples with dry ice, the samples and dry ice should be in the box, but do not seal the box before inspection by EHS. Remove any old labels that are not associated with this shipment.