To make it easier for your healthcare provider to order Cologuard, fill out as much of the information as you can below.
Once you're done, you'll be able to print a customized PDF order form that you can bring to the office. Then, your healthcare provider can complete it and send it back to us for processing.
Remember! Only your healthcare provider can determine if Cologuard is right for you.
Trying to view or edit your PDF after generating it? Please download Adobe Reader (it’s free) for best results.