Supplies Request Form

Rabkin Dermatopathology provides all packing and shipping supplies for specimen shipping including fixative solutions such as Pen Fix and Michel's Medium, and specimen containers. We also include FedEx pre-paid shipping labels so that you do not pay for the shipping of specimens to our lab.

To reorder any supplies, please fill out the following supply request form or you may alternately download it and either mail it to us with your next specimen shipment or fax it to (412) 968-5673.

Your order will be filled and shipped to you, in most cases the same day it was received.

Office name:
Shipping Addr:

City:
State:	We only conduct business within the contiguous United States.
Zip Code:
Email:

Pre-addressed shipping boxes and bags
Box of 32 small formalin specimen containers (includes 4 strips of specimen container labels per flat)
Packs of 3 large (Pen-Fix) specimen containers
Biohazard bags (50 bags/pack)
Packs of 50 request slips "Request for Dermatopathology Services"
Packs of 50 patient billing information cards
RDL Waterproof ink pens
Direct IF bottles (Michel's medium pks of 5)
Supply request forms (pads of 50)

Notes / special requests:

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