cologuard form pdf

Cologuard Form PDF: A Comprehensive Guide (Updated 12/24/2025)

Cologuard, a noninvasive stool DNA test, requires a specific order form for processing; conveniently, you can download this form as a PDF directly from Exact Sciences Laboratories.

This guide provides essential details regarding accessing, completing, and submitting the Cologuard order requisition form, ensuring a smooth screening process.

The PDF form is crucial for initiating the test, and staying updated with the latest version guarantees accurate processing and efficient results delivery.

What is Cologuard?

Cologuard is a remarkably innovative and FDA-approved noninvasive screening test designed for colorectal cancer, utilizing a simple stool sample collected at home. Unlike traditional methods like colonoscopies, Cologuard doesn’t require bowel preparation or sedation, offering a more comfortable experience for patients.

The test analyzes the stool sample for both altered DNA and blood, both indicators of potential colorectal cancer or precancerous polyps. It’s a multi-target approach, meaning it looks for multiple biomarkers to increase accuracy. If results are positive, a colonoscopy is recommended for further investigation.

Cologuard is intended for individuals aged 45 or older who are at average risk for colorectal cancer, providing a convenient alternative to more invasive screening options. The test’s accessibility and ease of use contribute to increased screening rates, potentially leading to earlier detection and improved outcomes. A physician’s order, submitted via a specific requisition form, is necessary to initiate the Cologuard process.

The Importance of Colorectal Cancer Screening

Colorectal cancer remains a significant health concern, but it’s also highly preventable with regular screening. Early detection, often through methods like Cologuard, dramatically increases the chances of successful treatment and survival rates. Screening identifies precancerous polyps, allowing for their removal before they develop into cancer.

Regular screenings, starting at age 45 for individuals at average risk, are crucial even in the absence of symptoms. Colorectal cancer often develops without noticeable warning signs in its early stages. Utilizing a Cologuard test, initiated with a completed order form, provides a convenient and effective way to monitor your colorectal health.

Proactive screening not only saves lives but also reduces the overall burden of colorectal cancer on healthcare systems. Choosing a screening method that aligns with your preferences and lifestyle, like the non-invasive Cologuard, can encourage consistent participation and improve long-term health outcomes.

Understanding the Cologuard Test

Cologuard is a noninvasive screening test for colorectal cancer and precancerous polyps, utilizing stool DNA analysis. Unlike colonoscopies, it doesn’t require bowel preparation or sedation, making it a more comfortable option for many. The test detects altered DNA and hemoglobin in the stool, indicators of potential cancer or advanced adenomas.

To initiate the Cologuard process, a completed order requisition form, downloadable as a PDF, is essential. This form, provided by your physician, authorizes the laboratory to process your sample. The test involves collecting a single stool sample at home using a provided kit and mailing it to Exact Sciences Laboratories.

Cologuard isn’t a diagnostic test; a positive result requires follow-up with a colonoscopy for definitive diagnosis. Understanding this distinction is vital when interpreting results and discussing them with your healthcare provider. The simplicity of sample collection, facilitated by the form, makes it a valuable screening tool.

Accessing the Cologuard Form PDF

The official Cologuard order form PDF is readily available for download, enabling convenient access for patients and healthcare providers alike.

Obtaining the correct form is the first step towards initiating the Cologuard screening process, ensuring accurate test ordering.

Where to Download the Official Cologuard Form

Downloading the official Cologuard order requisition form is a straightforward process designed for ease of access by both patients and physicians. The primary source for obtaining this crucial document is the Exact Sciences Laboratories website. Navigating to their official webpage ensures you receive the most current and accurate version of the form, vital for proper test processing and reliable results;

Several online resources may offer links to the Cologuard form, however, it’s always best practice to directly source it from Exact Sciences to avoid outdated or potentially inaccurate versions. The website typically features a dedicated section for healthcare professionals, making the download process simple and efficient. Look for clearly labeled buttons or links specifically stating “Order Form” or “Requisition Form” – often available in PDF format for universal compatibility.

Always verify the date on the form to confirm you are utilizing the latest iteration, as updates may occur periodically to reflect changes in testing protocols or billing procedures. Using an outdated form could potentially cause delays in processing or issues with insurance coverage.

Direct Link to the Exact Sciences Laboratories Cologuard Order Requisition Form

For immediate access, the Exact Sciences Laboratories provides a direct link to the Cologuard Order Requisition Form in PDF format. This streamlined approach eliminates the need for extensive website navigation, allowing healthcare providers and patients to quickly obtain the necessary documentation. Downloading directly from this source guarantees you have the most up-to-date version, minimizing potential errors or processing delays.

Clicking this link will initiate an automatic download of the PDF form to your device. Ensure your browser is configured to allow PDF downloads, or the form may open in a new tab instead. The form is designed for easy completion and includes clear instructions for both patient and physician sections.

Please note that links can occasionally change; however, searching “Exact Sciences Cologuard Order Form” will consistently lead you to the official download page. Always double-check the file name and date to confirm authenticity before completing and submitting the requisition.

Ensuring You Have the Latest Version of the Form

Utilizing the most current Cologuard Order Requisition Form is paramount for a seamless testing experience. Exact Sciences Laboratories periodically updates the form to reflect changes in guidelines, billing procedures, or test protocols. Downloading the form directly from the official Exact Sciences website, as described previously, is the most reliable method to guarantee you possess the latest iteration.

Always verify the “Revision Date” located on the form itself. If the date is older than December 24, 2025, it’s advisable to download a fresh copy. Using an outdated form could lead to processing delays or even rejection of the sample.

Regularly checking for updates, especially if you frequently order Cologuard tests, is a proactive step. Minor revisions may not be widely publicized, so a direct check is recommended. Maintaining compliance with the current form ensures accurate results and efficient insurance processing.

Completing the Cologuard Form

Cologuard’s order requisition form requires meticulous completion of patient, physician, and insurance details for accurate processing and billing purposes.

Ensure all sections are fully and legibly filled out.

Patient Information Section: What’s Required

The Patient Information section of the Cologuard form PDF demands comprehensive details to accurately identify and process the sample. This includes the patient’s full legal name, date of birth, complete home address, and a valid contact phone number.

Crucially, the form requires the patient’s gender and race/ethnicity. Providing accurate information here is vital for statistical analysis and ensuring the test’s effectiveness across diverse populations.

Furthermore, the patient must provide their signature and the date of signature, confirming their consent for the test. Without a valid signature, the sample cannot be processed.

It’s essential to double-check all entered information for accuracy, as even minor errors can cause delays or rejection of the form. Legibility is also paramount; printed names are preferred over cursive handwriting where possible.

Physician Information Section: Necessary Details

The Physician Information section of the Cologuard form PDF is critical for proper test ordering and result reporting. This section necessitates the physician’s full legal name, professional credentials (e.g., MD, DO), and National Provider Identifier (NPI) number – a unique identification number for healthcare providers.

A complete practice address, including street address, city, state, and zip code, is also required. The physician’s direct contact phone number and fax number must be provided for efficient communication regarding test results and any necessary follow-up.

The ordering physician must sign and date the form, signifying their medical responsibility for the test request. This signature confirms that the Cologuard test is medically appropriate for the patient.

Accuracy in this section is paramount; incorrect or missing information can lead to billing issues or delays in receiving crucial test results. Double-checking all details before submission is strongly advised.

Insurance Information: Billing and Coverage

The Insurance Information section of the Cologuard form PDF is essential for accurate billing and determining patient coverage. This section requires the patient’s primary insurance provider’s name, policy number, and group number, if applicable.

Providing accurate insurance details helps ensure timely claim submission and processing. It’s crucial to verify coverage with your insurance plan before completing the form, as coverage for colorectal cancer screening tests can vary significantly.

The form may also request the patient’s secondary insurance information, if applicable. Including this information can help maximize coverage benefits;

Patients are ultimately responsible for any out-of-pocket costs, such as deductibles, co-pays, or co-insurance, even with insurance coverage. Understanding potential costs beforehand is recommended. Exact Sciences offers resources to help estimate potential expenses.

Submitting the Cologuard Form

Completed Cologuard forms can be submitted via email, fax, or a secure URL share, offering convenient options for healthcare providers and patients alike.

Choose the method that best suits your practice’s workflow for efficient test ordering.

Methods of Submission: Email, Fax, or URL Sharing

Submitting the completed Cologuard Order Requisition Form is streamlined through three convenient methods: email, fax, or secure URL sharing. Each option caters to different preferences and technological capabilities within healthcare settings.

Email submission allows for quick and direct transmission of the PDF form to Exact Sciences Laboratories. Ensure the form is securely attached and sent to the designated email address. Faxing remains a reliable option for those preferring traditional methods, providing a documented record of transmission. Finally, secure URL sharing offers a modern, efficient approach, enabling providers to share a link to the completed form directly with the laboratory.

Choosing the most appropriate method depends on your practice’s existing infrastructure and security protocols. Regardless of the chosen method, verifying successful submission is crucial to ensure timely processing of the Cologuard test request.

Fax Number for Form Submission

For healthcare providers choosing to submit the Cologuard Order Requisition Form via fax, the dedicated fax number is 1-877-329-1483. This fax line is specifically designated for receiving Cologuard test requests, ensuring efficient routing to the appropriate processing team at Exact Sciences Laboratories.

When preparing the form for fax transmission, please verify that all sections are fully completed and legible. Poorly transmitted or incomplete forms may result in delays or rejection. It is recommended to use a reliable fax machine and confirm successful transmission with a confirmation report.

Retain a copy of the fax confirmation report for your records as proof of submission. Utilizing the designated fax number guarantees secure and direct delivery of the Cologuard order, initiating the colorectal cancer screening process promptly.

Email Address for Form Submission

While fax submission is a primary method, Cologuard Order Requisition Forms can also be submitted securely via email to orders@cologuard.com. This email address is exclusively monitored for incoming test requests, ensuring prompt attention from the Exact Sciences Laboratories team.

When emailing the completed form, it is crucial to attach it as a high-quality PDF document. Avoid sending scanned images or other file formats, as these may hinder processing. Ensure the PDF is clearly legible and contains all required patient and physician information.

For security purposes, consider encrypting the email or utilizing a secure file transfer method. Retain a copy of the sent email with the attached form for your records. Email submission offers a convenient alternative to faxing, streamlining the Cologuard ordering process.

Understanding the Results

After submitting the Cologuard form, expect results within approximately two weeks; these will be communicated to both you and your physician for review.

Interpreting outcomes requires professional guidance, dictating necessary follow-up procedures based on whether the test is positive or negative.

What to Expect After Submitting the Form

Following form submission, the sample kit will be mailed to Exact Sciences Laboratories for analysis; processing typically takes around two weeks, though timelines can vary slightly.

During this period, you won’t receive interim updates, as the lab meticulously analyzes the stool sample for altered DNA indicators associated with colorectal cancer or precancerous polyps.

Results are not directly sent to patients; instead, they are securely communicated to the physician listed on the requisition form.

Your doctor will then contact you to discuss the findings, explain their implications, and outline any necessary next steps, such as a colonoscopy if the test returns a positive result.

It’s crucial to maintain communication with your healthcare provider throughout this process and schedule a follow-up appointment promptly upon notification of the results.

Remember, early detection is key to successful treatment!

Interpreting Your Cologuard Results

Cologuard results are categorized into two primary outcomes: positive or negative. A negative result indicates no cancer or precancerous polyps were detected, and routine screening intervals, as recommended by your physician, should be followed.

However, a positive result doesn’t necessarily mean you have cancer; it signifies that altered DNA indicative of potential cancer or advanced adenomas was found in the sample.

A positive result always necessitates a diagnostic colonoscopy to investigate further and determine the cause of the positive finding.

It’s vital to understand that Cologuard is a screening tool, not a diagnostic one; a colonoscopy provides a definitive diagnosis.

Your physician will thoroughly explain your results, discuss the implications of a positive finding, and schedule a colonoscopy if required, ensuring appropriate follow-up care.

Don’t hesitate to ask questions and seek clarification!

Follow-Up Procedures Based on Test Outcomes

Following a Cologuard test, specific procedures depend entirely on the results received. A negative result typically means continuing with the recommended screening schedule – usually repeating the Cologuard test every three years, as advised by your doctor.

However, a positive result mandates a timely colonoscopy, generally within 12 months. This is crucial for identifying the source of the altered DNA detected in the stool sample.

During the colonoscopy, the physician can remove any polyps found and obtain biopsies for further analysis, providing a definitive diagnosis.

If the colonoscopy reveals no cancer or advanced adenomas, your doctor will determine the appropriate future screening plan.

Regardless of the outcome, consistent communication with your healthcare provider is paramount for personalized follow-up care and maintaining optimal colorectal health.

Adhering to these guidelines is key!

Cologuard and Insurance Coverage

Cologuard is frequently covered by major insurance plans, but verifying your specific eligibility is essential before proceeding with the test and submitting the form.

Understanding potential out-of-pocket costs and available financial assistance programs can alleviate financial burdens associated with colorectal cancer screening.

Checking Your Insurance Eligibility

Determining your insurance coverage for Cologuard is a crucial first step before completing and submitting the Cologuard form PDF. Most major insurance providers offer coverage, but specific benefits vary significantly based on your plan type – HMO, PPO, Medicare, or Medicaid.

Exact Sciences Laboratories provides a convenient online eligibility checker on their website. This tool allows you to input your insurance information to quickly assess your potential coverage and estimated out-of-pocket costs. Alternatively, you can directly contact your insurance provider’s member services department.

When contacting your insurer, specifically inquire about coverage for “stool DNA testing” or “Cologuard” (specifically using that name). Ask about any required pre-authorization or referrals needed for the test to be covered. Confirm if there are any limitations, such as age restrictions or frequency limitations. Having this information readily available will streamline the billing process and prevent unexpected expenses. Keep detailed records of your conversations, including the date, time, representative’s name, and confirmation number.

Potential Costs Associated with Cologuard

The cost of Cologuard can vary considerably depending on your insurance coverage and any applicable deductibles, co-pays, or co-insurance. If your insurance doesn’t fully cover the test, you’ll be responsible for the remaining balance.

As of late 2025, the list price for a single Cologuard test kit is approximately $400. However, many individuals pay significantly less due to insurance benefits. It’s essential to verify your specific costs with both your insurance provider and Exact Sciences Laboratories.

Exact Sciences offers a Cologuard Savings Program for eligible individuals who may face financial hardship. This program can substantially reduce your out-of-pocket expenses. Details regarding eligibility criteria and application procedures are available on their website. Be prepared to provide documentation of your income and insurance status when applying. Understanding these potential costs upfront allows for informed financial planning.

Financial Assistance Programs Available

Exact Sciences Laboratories recognizes that the cost of colorectal cancer screening can be a barrier for some individuals, and therefore offers several financial assistance programs to help make Cologuard more accessible.

The Cologuard Compassionate Care program is designed for uninsured and underinsured patients who meet specific income requirements. This program can significantly reduce or even eliminate the out-of-pocket cost of the test. Eligibility is determined on a case-by-case basis.

Additionally, Exact Sciences partners with various foundations and organizations that provide financial aid for cancer screening and diagnostic testing. Information about these partnerships and application processes can be found on the Exact Sciences website. Patients can also explore options through non-profit organizations dedicated to colorectal cancer support. These programs aim to ensure that financial constraints do not prevent individuals from receiving potentially life-saving screenings.

Additional Resources

Explore the Exact Sciences Laboratories website for comprehensive Cologuard information, including FAQs and support. Discover colorectal cancer awareness organizations for further guidance.

Access detailed information and support regarding the Cologuard test and colorectal health.

Exact Sciences Laboratories Website

Exact Sciences Laboratories’ official website is the primary hub for all things Cologuard, offering a wealth of information for patients and healthcare professionals alike. You’ll find detailed explanations of the test itself, including how it works, its accuracy, and the science behind the multi-target stool DNA technology.

Crucially, the website hosts the official Cologuard order requisition form in PDF format, ensuring you always have access to the most current version. Beyond the form, the site provides extensive resources on colorectal cancer screening guidelines, risk factors, and prevention strategies.

Patients can explore a dedicated FAQ section addressing common questions and concerns, while healthcare providers can access clinical data, educational materials, and ordering information. The website also features contact information for customer support, allowing you to directly reach out with any specific inquiries regarding the Cologuard test or the ordering process.

Frequently Asked Questions (FAQ) about Cologuard

A common question is: “Where can I find the Cologuard order form PDF?” The answer is readily available on the Exact Sciences Laboratories website, ensuring you always access the latest version. Another frequent inquiry concerns form completion; it’s vital that both patient and physician sections are filled out accurately and completely to avoid processing delays.

Many ask about submitting the form; options include secure email, fax, or a unique URL for direct upload. Regarding insurance coverage, the FAQ clarifies that eligibility varies, and patients should verify their benefits beforehand. A key question addresses what happens after submission; you’ll receive a collection kit and detailed instructions.

Finally, the FAQ explains interpreting results; your physician will discuss outcomes and any necessary follow-up procedures. These FAQs are designed to streamline the Cologuard process, providing clear answers to common concerns about the form and the test itself.

Colorectal Cancer Awareness Organizations

Understanding the importance of colorectal cancer screening, like using the Cologuard form PDF, is greatly supported by dedicated organizations. The American Cancer Society (cancer.org) provides comprehensive information on prevention, detection, and treatment, alongside resources for navigating the Cologuard process.

The Colorectal Cancer Alliance (ccalliance.org) offers patient support, advocacy, and educational materials, including guidance on understanding test results obtained through the Cologuard test initiated with the downloadable form. Fight Colorectal Cancer (fightcrc.org) focuses on research and advocacy, empowering patients and families.

These organizations often provide financial assistance information, which can be helpful when considering the costs associated with Cologuard. They also offer valuable resources for completing and submitting the form, ensuring individuals feel informed and supported throughout their screening journey.