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Intent to Ship Hazardous Materials
Step 1

Purpose: Why Use This Form?

The purpose of this online form is to notify Safety Services of your intent to ship any material classified as hazardous as described in the Department of Transportation (DOT) Hazardous Materials regulations, at 49 CFR parts 171-180.

The use of this form applies only to those individuals who have previously taken an official Safety Services Hazmat Shipping training course. If you have not taken a Safety Services Hazmat Shipping course within the past 24 months, you must attend another Safety Services Hazmat Shipping training course to become re-certified.

If you are unsure of your qualifications, please contact the Safety Services office for your campus. It is always better to choose the side of safety.

 ---    Fill out this form carefully and accurately, as you will digitally sign this form prior to submitting it.

Department Information

Please complete this section with accurate details about your Department.

Principal Investigator

Corresponding IBC Protocol (If Applicable)

Dept./Division Name

Phone Number

P.I. Email Address



Texas Tech University Health Sciences Center, Department of Safety Services, 3601 4th Street MS 9020, Lubbock, TX 79430, Phone: 806.743.2597


If you need assistance with this web application, or wish to provide comments or feedback, please contact the Safety Services Department Programmer, Lubbock, TX at 806.743.2597 ext. 277