HNHS Sharps Container Order Form

Per your request, we will happily fulfill your Sharps Container request and deliver them at your next regularly scheduled pick-up. For your convenience, the price of the container order will be added to your medical waste invoice.

If you have any questions, please call (269) 329-3200.

NOTE – 6% Michigan sales tax will be added to the total amount of the purchase. Prices are subject to change without notice.

Customer Information

Customer Name*

Street Address*

City / State / Zip*

Contact Name*

Phone Number*

Date*

Enter the required quantity of Sharps Containers in the field below.

Quantity Requested	Size & Description	Price
	Small Sharps Container with Screw on Lid (1.5 Quart)	$7.25
	5 Quart Sharps Container (Wall mountable)	$7.75
	Wall Mount Bracket for 5 Qt. Container - Optional	$14.00
	3 Gallon Sharps Container	$15.00