Cologuard order form 2026

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Click ‘Get Form’ to open the Cologuard order form in the editor.
Begin by filling out the 'Provider Information' section. Enter the healthcare organization name, provider name, and contact details including phone number and secure fax number for results.
In the 'Order Information' section, provide the necessary ICD-10 codes that best describe the reason for testing. Ensure you include your NPI number and location address.
Next, complete the 'Patient Demographics' section. Fill in patient ID/MRN, first and last name, date of birth, sex, and shipping address.
For insurance billing information, indicate whether Exact Sciences should bill insurance. If yes, complete policyholder details and insurance carrier information.
Finally, review all entries for accuracy before signing in the 'Certification' section. Ensure you date your order before submitting.

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