Order a Pickup

In order to schedule a pickup, please submit the information below or call 1-800-257-3527

Pickup Order Form

Facility Name:
 

Contact:
 

Address:
 

Phone:
 

City:
 

Email:

State:
 

DEA ID:
 

Zip:
 

No. of Boxes:
 

            
Type of Business:

Pick Up Date: