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Sample Guard Logistics
919-691-6722
info@sampleguardlogisiticsllc.com
Franklinton, NC
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Facility / Organization Name
*
Primary Contact Name
*
Title / Role
*
Phone Number
*
Email Address
*
Pickup Address (City/State only)
*
Delivery Address (City/State only)
*
Multiple Locations?
Yes
No
Service Type
Same-Day Medical Specimen Pickup
STAT / Expedited Delivery
Scheduled Daily Route
Pharmaceutical Delivery (non-controlled)
Medical Records / Secure Documents
Other
How often do you need courier service?
One-time
Daily
Weekly
As-needed / On-call
Estimated number of pickups per day or week
1–2
3–5
6–10
10+
Specimen Type (No PHI)
Blood
Urine
Tissue
Pathology
Mixed / Various
Temperature Requirements
Ambient
Refrigerated
Frozen
Unsure
Special Handling Required?
Chain-of-Custody Documentation
Temperature Logs
None
Preferred Pickup Time Window
Morning (7 AM – 10 AM)
Midday (10 AM – 2 PM)
Afternoon (2 PM – 5 PM)
After-Hours / STAT
Do you require after-hours or weekend service?
Yes
No
Occasionally
Dropdown
First Choice
Second Choice
Third Choice
Additional Notes or Special Instructions (Optional)
(Please do not include PHI)
How Did You Hear About Us? (Optional)
Referral
Google Search
LinkedIn
Other
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