Bio-hazardous Waste Collection Request Form

HSAS&F

Set up an account by filling out the Biohazardous/Regulated Waste form below. Please contact Waste Management at 1-855-427-1999 or HealthcareWasteNW@trilogymedwaste.com or Laboratory Services at 206-543-8869 or biowaste@uw.edu with any questions.

I have completed the required training per DOT requirements.*
More info on the training course “Shipping Regulated Medical/Biohazardous Waste by Contracted Carrier” offered by EH&S.
- Yes
- No
Describe in detail your biohazardous waste stream (materials, quantity/volume, other). Be as descriptive as possible.*
Container Size*
View containers here
- 17 gallon tub
- 31 gallon tub
- 43 gallon tub
- 30 gallon box
- 23 gallon box
Name of Operation/Facility/Lab*
Budget Number*
Building Name and Address*
Room/Suite Number*
Department*
PI Name*

First

Last
PI Phone*
PI Email*
Requestor Name (if different)

First

Last
Billing Contact*
- Same as PI
- Different
Billing Contact Name*

First

Last
Billing Contact Phone*
Billing Contact Email*
Hours of Operation*
Pickup Schedule*
Delivery Instructions

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