Order shipment
Sample shipment
  Please fill in all information in order for us to assist you in setting up a shipment of samples. Fields marked with * have to be filled in.

Hospital Name *

 

     

Contact person *

 

   
 

Address *

 

   

Please enter precise address where courier can do pickup

     

Phone*

 

Fax

 

E-mail address

 

     

Number of samples/ tubes/ vials to be shipped?*

 

     

Additional comments or questions