Shipping Form

Your Information

This information will be used for questions and contact information on the shipping label

Name*

First Last

Phone

Email*

MD Number*

Department*

Building Name (if known)

Building Address*

Company or Name of Person*

Address Type*

Address*

NOTE: Cannot ship to a P.O. Box or International Addresses (excluding Canada and Puerto Rico)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Number of items/boxes being sent to this address*

NOTE: If you have additional packages going to a different address, please submit a separate form.

Delivery Method*

UPS Service*

Insurance Required*

The MDS shipping department will shop for the best rate when using freight. We will contact you with the freight cost prior to shipping.