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Schedule your Pickup
Clinic Name
*
Clinic Code
Street Address
*
Address Line 2
City
*
State
*
Zip Code
*
County
*
Mobile
Baldwin
Other
Clinic Contact
*
Phone Number
*
Email Address
*
Pickup Information
Please note the cut-off time of 1:00pm CST for all courier pickups.
By submitting this form, you are agreeing to all terms outlined by the Synergy shipping policy.
Pickup Date:
*
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Pickup Time?
*
Optional Instructions/Questions
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