MedClean Management Solutions Inc., BioMedical Waste Management Virginia, Sharps Containers, Medical Waste Pickup, Disposal Of Infectious Waste, Reusable Sharps Container, Virginia

*Indicates a required field

*Doctor/Facility Name	:

Street Address	:

Suite/Floor	:

City	:

State	:

*E-Mail	:

*Phone	:

Fax	:

Office Hours	:	Example: M-F 8am-5pm, closed for lunch 12-1pm

Contact Person	:

Alternate Contact Person	:


Frequency of service?	:

Biohazard Waste Sharps, cultures and stocks, blood and blood-borne pathogen waste. (Red bag waste)


		Qty
Minimum Pickup up to 5 Gallon Container	:

18 Gallon Container or Medium Box	:


32 Gallon Container or Large Box	:

48 Gallon Container	:

Incineration Waste Chemotherapy waste, pathological waste, biological waste, expired medications.


		Qty
Minimum Pickup up to 5 Gallons	:

Medium Box 20 Gallons	:

Large Box 30 Gallons	:

Do you require any supplies? If so, please complete the section below.


		Qty
5 Gallon Container	:

32 Gallon Container	:

48 Gallon Container	:

2 Qt. Sharps Container	:

5 Qt. Sharps Container	:

2 Gallon Sharps Container	:

8 Gallon Sharps Container	:

3 Gallon Pharmaceutical Container	:

Medium Box (20 Gallons)	:

Large Box (30 Gallons)	:

Biohazard Liners	:

Biohazard Sign	:

Biohazard Liners	:

We proudly carry Tyco Kendall sharps containers. If you don't see the type or size of container or sharps container you're currently using, please indicate the manufacturer and order number under Notes/Special Instructions, and we'll try to get it for you.

Notes/Special Instructions	: