Regeneron Service Request

Thank you for requesting receptacle pick-up. Please complete this form and Envita will work with our supplier partners to schedule a pick-up at your site. Provide as much detail as possible to help us process your request efficiently.

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Container Type

Container Location

Material Description

Urgency of Service

schedule email organization

Handling Instructions and Additional Notes

First Name

Last Name

Phone

I have permission to schedule service on behalf of my organization

Service Address

Address Line 1

City

State

Zip Code

Do you need a schedule receipt/additional confirmation?

List email addresses to receive the receipt/confirmation (use a comma to separate addresses)