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Vermont Dermatopathology |
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| Toll Free: 888-864-4642 | |
| Phone: 802-658-6269 | |
| Fax: (802) 860-4642 | |
| www.vermontdermpath.com | |
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REQUEST FOR SUPPLIES | |
| SEND SUPPLIES TO DR. | _____________________________________ |
| _____________________________________ | |
| _____________________________________ | |
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___ Requisition forms (lab request forms) ___ Biohazard Bags ___ 30 ml 10% Formalin Containers ___ 60 ml 10% Formalin Containers ___ Container Labels ___ Printable Container Labels ___ IF Transport Media ___ Supply Order Forms Comment/other ___________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ |
FAX Request to | 802-860-4642 |
OR | |
MAIL Request to |
Vermont Dermatopathology 50 Timber Lane South Burlington, VT 05403 |