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Get MA PS-CT-3-08 2009-2024

CHEMICAL EXPOSURE CLINICAL SPECIMEN SHIPPING MANIFEST DIRECTIONS: Please fill out this form completely and put in a zip-loc plastic bag. Place the bag on top of the secondary container. Please use one form per shipping container. GENERAL INFORMATION: SHIPPING INFORMATION: Shipped By:______________________________________ Time: __________AM / PM (circle one) Address: ____/____/_______ ________________________________ Date: CONTACT NAMES: CONTACT TELEPHONE NUMBERS: Primary: Primary: .

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