01Pick-Up Address Scheduled Pickup Date and time City State —Please choose an option—TXOKC Zip 02 Destination Address Delivery Date City State —Please choose an option—TXOKC Zip Multiple route location if yes thick the box to get further message yes 03Delivery Information Delivery type —Please choose an option—Medical courier DeliveryBusiness delivery Package Size EnvelopeSmall boxesAccessoriesBoxesProof of Delivery/Signature options —Please choose an option—Signature RequiredSignature Not Required Load Type Car/sedanvanTruck Please Describe(dimensions, weight, number or pieces) 04Customer InformationEmail to NotifyUpon Shipment Order Service bid amount $ By using this form you agree with the storage and handling of your data by this website.
