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  • Wi Cologuard Form Frm-3004-05-c 2019

Get Wi Cologuard Form Frm-3004-05-c 2019-2025

P: 844-870-8870 ExactLabs.com NPI: 1629407069 TIN: 463095174 Recommended: type all Provider information. Editable, printable PDF available at exactlabs.com PROVIDER INFORMATION ORDER INFORMATION This section is not intended to influence the medical judgment of an ordering provider in determining whether this test is right for any particular patient. The following codes are listed as a convenience. Ordering practitioners should report the diagnosis code(s) that best describes the reason for.

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How to fill out the WI Cologuard Form FRM-3004-05-c online

Filling out the WI Cologuard Form FRM-3004-05-c online is a straightforward process that ensures you provide all necessary information for the stool-based DNA test. This guide will walk you through each step, ensuring you complete the form accurately and efficiently.

Follow the steps to successfully complete the online form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Fill in the provider and order information. Ensure you type all necessary details, including healthcare organization name, provider name, and ICD-10 codes that pertain to the test.
  3. Complete the certification section by confirming your status as a licensed healthcare provider. Fill in your city, state, zip, and phone number. Note that to receive results, a secure fax number should be provided.
  4. Next, enter the patient demographics. Include the patient ID/MRN, first name, last name, date of birth, and contact numbers. If applicable, provide the patient’s language preference.
  5. Fill in the shipping and billing address as necessary, indicating if the shipping address is the same as the billing address.
  6. Optionally complete the patient ethnicity and race section, marking if the patient is of Hispanic or Latino origin and selecting any applicable race categories.
  7. Provide patient insurance and billing information, including policyholder details and insurance carrier. Make sure to state whether the patient would like Exact Sciences to bill their insurance.
  8. In the authorization section, ensure the patient signs and dates the form to authorize billing and confirm financial responsibilities.
  9. Once all sections are completed, save the form. You can then download, print, or share the final document as needed.

Complete the WI Cologuard Form FRM-3004-05-c online today to ensure timely processing of your test.

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Unfortunately, you cannot obtain Cologuard without a doctor’s order. A qualified healthcare provider must assess your health status and determine the appropriateness of the test. This ensures you receive the best care. To proceed, make an appointment with your healthcare provider and request the WI Cologuard Form FRM-3004-05-c to facilitate the process.

You can obtain Cologuard by scheduling an appointment with your healthcare provider to discuss your screening options. After receiving a recommendation for the test, you will need to fill out the WI Cologuard Form FRM-3004-05-c. This form helps ensure you receive the correct test kit. Once the process is initiated, your provider will guide you through the next steps.

You can contact Cologuard through the contact information provided in the WI Cologuard Form FRM-3004-05-c. This typically includes a customer service phone number and email. Don't hesitate to reach out with your questions or for assistance, as the team is prepared to help you.

Requesting Cologuard involves completing the WI Cologuard Form FRM-3004-05-c with your personal details and any necessary medical information. Once you fill it out correctly, you can send it via fax or utilize their online system. If you encounter any questions, customer service representatives are available to assist you.

You can obtain Cologuard by filling out the WI Cologuard Form FRM-3004-05-c and submitting it through the designated channels provided on the form. Once your request is processed, you will receive instructions for the next steps, including sample collection. It's straightforward, and our platform can help you navigate through the process seamlessly.

To request results for Cologuard, you may need to use the WI Cologuard Form FRM-3004-05-c to submit your request to the testing lab. Make sure to include all necessary information on the form to facilitate faster processing of your results. You should also check the associated contact details for follow-up inquiries regarding your results.

You can contact Exact Sciences Cologuard by visiting their official website for customer service options. Additionally, using the contact information provided on the WI Cologuard Form FRM-3004-05-c will direct you to the right department. Don't hesitate to reach out if you have specific questions or need assistance.

To submit Cologuard, you should first complete the WI Cologuard Form FRM-3004-05-c and then send it via the preferred submission method outlined on the form. You can choose to fax or mail the completed form, depending on your preference. Following these prescribed steps helps in processing your submission efficiently.

To order Cologuard using the WI Cologuard Form FRM-3004-05-c, you can fax your order to the number provided by Exact Sciences. For the most current contact details, including the fax number, please refer to your specific form instructions. Ensuring you have the correct information can speed up your ordering process.

The fax number for sending Cologuard records requests may be provided on the WI Cologuard Form FRM-3004-05-c. To ensure the request reaches the correct department, refer to the official documentation or the platform where you obtained your order.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232