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Supplies Requisition Form

Please fill out the following fields to obtain sample collection supplies and/or shipping supplies. Orders will be verified with accounts management department before shipment is released. All orders will be shipped FedEx 2nd day air unless otherwise specified and agreed upon via the CTR Shipping Department. This form is for active accounts only. Please contact the lab directly if you would like to register for our toxicology services.

Name*
First Name Last Name
Name of Practice*
Shipping Address*
Street Address Suite # City State / Province / Region ZIP / Postal Code
Phone*
Email*
Urine Toxicology Requisition Forms
Forms are pre-populated based on practice specifications.
- 50 CTR Requisition Forms
- 100 CTR Requisition Forms
- 200 CTR Requisition Forms
Urine Collection Kits
- 50 CTR Sterile Collection Cups w/ Haz Bags and Pads
- 100 CTR Sterile Collection Cups w/ Haz Bags and Pads
- 200 CTR Sterile Collection Cups w/ Haz Bags and Pads
Federal Express Shipping Supplies
- One Month's Supply of Shipping Labels (20)
- One Month's Supply of Boxes (20)
- One Month's Supply of Clinical Paks (20)
- All of the above
Notes / Special Requests

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8415 Progress Drive, Ste V
Frederick, MD 21701

lab@ctrlabs.com

Phone: 240-397-7060

Billing Support: 1-888-638-2704

Fax: 301-694-4780

Monday – Friday:
8:00 AM – 6:00 PM
Saturday: Closed
Sunday: Closed

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