Submit A Specimen

Name *

First Name

Last Name

Phone *

Please provide a call back number.

(###)

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Pick-Up Address

The location where we will pick up your specimens.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Specimen Storage *

Check all that apply.

Specimen was bagged

Specimen was securely tied

Specimen was labeled with location and trap date

Specimen was frozen within 12-24 hours of trapping.