Midwest Cancer Screening - Supplies Order
Contact Person:
Clinic Name:
Clinic Code:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
eMail Address:
Comments:
Order supply quantities below:
Click on links below to see full size images of supplies.
Pap Report Forms
Qty:
Clinical Test Forms
Qty.
Histology Request Forms
Qty.
Histology Request Forms (Breast and Cervical Program)
Michigan
Clinics only.
Qty.
Glass pap slides (frosted tip) 72 slides per box
Qty.
Cytobrushes (bag of 100)
Qty.
Cervical sticks
Qty.
Cytology Fixative (4 oz. Bottle)
Qty.
Plastic slide containers for shipping glass pap slides (each container holds 5 slides)
Qty.
Thin Prep Pap Test Kits (25 per flat)
Qty.
White Tyvek Mailing Envelopes
Qty.
White Tyvek Padded Mailing Envelopes
Qty.
Biohazard Bags
Qty.
Supply order cards (to order by mail)
Qty.
Histology vials (20 ml.)
Qty.
Chlamydia/Gonorrhea DNA Probes (Gen-Probes) Female Kits
Qty.
Chlamydia/Gonorrhea DNA Probes (Gen-Probes) Male Kits
Qty.
Herpes Test Swabs
Qty.
Beta Strep Test Swabs
Qty.
HPV Cervical Sampler Test Kits
Qty.
Serum Separator Tubes (Blood draw tubes)
Qty.
Serum Shipping Tubes
Qty.
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