Can the form be signed electronically?

Yes. Electronic signatures that meet the ESIGN Act standard (15 U.S.C. §7001) and applicable state UETA rules are acceptable provided the signer demonstrates intent, consents to electronic records, attribution is captured, and the record can be retained. For consumer-facing healthcare records, include the ESIGN consumer disclosure where required.

What if a field was entered incorrectly?

If an error is discovered before lab accessioning, correct the form and re-submit according to the lab's amendment procedure. After accessioning, notify the lab immediately; corrected orders may require specimen re-labeling or recollection to preserve chain-of-custody.

Why did the lab reject my specimen?

Common reasons include mismatched identifiers, missing collection date, or damaged packaging. The lab will typically provide a rejection reason; follow their guidance on recollection timelines to avoid invalidation of the order.

Is patient consent required to order Cologuard?

Yes. Documented patient consent for testing and for electronic communications is required. When using electronic records, comply with ESIGN consumer disclosure requirements and retain demonstrable consent evidence in the record.

How should signed forms be stored?

Store signed orders and results in secure, access-controlled systems with encryption at rest and in transit. Maintain audit trails showing signer attribution, timestamps, and any amendments to meet HIPAA and organizational retention policies.

Who is authorized to sign the order?

Typically an authorized ordering clinician (physician, nurse practitioner, or physician assistant) signs and attests to medical necessity. Delegated staff may complete the form but a licensed provider's signature or electronic attestation is required for most orders.

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Cologuard Order Form

Cologuard Order Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

What the Cologuard Order Form Is

The Cologuard Order Form is a clinical requisition used by U.S. healthcare providers to request an at‑home Cologuard colorectal cancer screening kit and laboratory analysis for a specific patient. It collects patient identifiers, clinical indications, insurance and billing details, specimen identifiers, and ordering clinician information. Laboratories use the completed form to verify patient eligibility, process specimens, and generate results for the ordering provider. The form can be completed on paper or electronically; when submitted electronically, ESIGN and UETA support e-signatures where permitted and HIPAA rules govern protected health information handling.

Why Accurate Orders Matter

The Cologuard Order Form standardizes patient and clinical data, reducing processing delays and lab rejections. Accurate completion supports insurer billing, ensures specimen traceability, and preserves compliance with HIPAA and ESIGN/UETA when using electronic submission and e-signatures.

Who Typically Completes the Cologuard Order Form

Typical users include ordering clinicians, nursing staff, laboratory intake personnel, and administrative staff responsible for billing and test coordination.

Primary care providers and gastroenterologists ordering the Cologuard screening for eligible patients.
Clinic staff who prepare requisitions, verify insurance, and issue patient kits at point of care.
Laboratory intake teams who match specimens to forms and manage processing and reporting.

Essential Elements of a Professional Cologuard Order Form

Essential Cologuard Order Form elements clarify responsibilities, capture clinical indications, and provide data needed for lab processing, billing, and traceability across the patient care pathway.

Patient Info

Full legal name, date of birth (MM/DD/YYYY), address, contact phone, and unique medical record or patient identifier to ensure correct kit assignment and result matching.

Clinical Data

Clinical indication for screening, relevant symptoms or history, current medications affecting test validity, and any prior colorectal cancer screening dates or results.

Insurance

Payer name, policy number, subscriber relationship, authorization or prior-authorization details when required, and billing preference to prevent claim denials and enable accurate patient responsibility calculation.

Specimen ID

Unique specimen or kit identifier, collection date, and chain-of-custody fields to maintain specimen integrity and allow lab accessioning without delay.

Ordering Clinician

Ordering provider name, NPI, clinic address, contact phone, and signature or electronic attestations confirming medical necessity and consent for testing.

Consent & Signature

Patient consent checkbox or signature, date of consent, and documentation of any disclosures required under ESIGN for electronic records and HIPAA for protected health information.

Security and Compliance Snapshot

Encryption: TLS 1.2/1.3 in transit, AES-256 at rest

HIPAA: HIPAA compliant; BAA required for PHI

Audit Trail: Comprehensive timestamps, IP, and action history

Authentication: Email, SMS, and advanced signer authentication options

Certifications: SOC 2 Type II, ISO 27001, PCI DSS

Regulatory Controls: Supports 21 CFR Part 11 controls where required

Consequences of Incorrect or Incomplete Orders

Lab Rejection: Specimen may be rejected or unprocessed

Billing Denial: Insurer claim denial or delayed payment

HIPAA Violation: Improper PHI handling raises compliance risk

Delayed Results: Patient care timelines can be extended

Specimen Loss: Recollection required, increasing cost and delay

Legal Exposure: Potential malpractice or administrative action

Common Mistakes to Avoid

Entering an incorrect or abbreviated patient name that doesn't match ID leads to specimen mismatch and processing delays.
Omitting ordering provider NPI or contact information prevents verification and can delay laboratory accessioning and reporting.
Missing or incomplete insurance and authorization details can cause claim denials and unexpected patient billing.
Failing to record the specimen collection date or proper kit ID often results in laboratory rejection and the need for recollection.

Step-by-Step: Filling Out the Cologuard Order Form

Follow these steps to complete a Cologuard Order Form accurately, whether using paper, an EHR integration, or an electronic submission portal.

01

Enter Patient Details: Full legal name, DOB, and contact information.
02

Verify Eligibility: Confirm screening indication and age criteria.
03

Add Insurance Info: Provide payer details and prior authorization if required.
04

Sign and Submit: Ordering clinician signs; submit via lab portal or secure upload.

Where to Send or Submit the Completed Form

Typical submission and processing flow for an ordered Cologuard kit, from provider order to lab reporting and result delivery.

Order Submission: Upload requisition to lab portal or fax per lab policy.
Kit Issuance: Clinic provides or ships kit to patient with instructions.
Patient Return: Patient mails sample using prepaid lab mailer.
Lab Processing: Lab accession, test processing, and result reporting to provider.

How to Configure an Online Cologuard Order Workflow

Configure online workflows to reduce errors: set required fields, enable auto-fill, and connect to EHR or billing systems for seamless data exchange.

Field	Configuration
Patient Consent	Required checkbox and signed date
Auto-fill Patient	Integrate with EHR to pre-populate demographics
Required Fields	Name, DOB, insurer, provider NPI
Signature Method	ESIGN-compliant e-signature or wet signature

Technical Requirements for Electronic Submission and Signing

Electronic submissions require PDF or DOCX files, secure transmission, and signer authentication compatible with ESIGN and HIPAA rules.

File Formats: PDF, DOCX, HTML supported
Authentication: Email, SMS, or advanced options
Integrations: EHRs, Google Workspace, NetSuite, Salesforce

eSignature Pricing and Feature Snapshot for Order Form Workflows

Comparison of common eSignature plans relevant to submission and signing of Cologuard Order Forms; signNow listed first per platform pricing and feature availability.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Varies	Varies	Varies	Varies
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	Varies	Varies

Frequently Asked Questions about the Cologuard Order Form

Answers to common questions about completion, e-signing, corrections, and lab rejections to reduce delays and compliance issues.

Need help? Contact support

Can the form be signed electronically?
Yes. Electronic signatures that meet the ESIGN Act standard (15 U.S.C. §7001) and applicable state UETA rules are acceptable provided the signer demonstrates intent, consents to electronic records, attribution is captured, and the record can be retained. For consumer-facing healthcare records, include the ESIGN consumer disclosure where required.
What if a field was entered incorrectly?
If an error is discovered before lab accessioning, correct the form and re-submit according to the lab's amendment procedure. After accessioning, notify the lab immediately; corrected orders may require specimen re-labeling or recollection to preserve chain-of-custody.
Why did the lab reject my specimen?
Common reasons include mismatched identifiers, missing collection date, or damaged packaging. The lab will typically provide a rejection reason; follow their guidance on recollection timelines to avoid invalidation of the order.
Is patient consent required to order Cologuard?
Yes. Documented patient consent for testing and for electronic communications is required. When using electronic records, comply with ESIGN consumer disclosure requirements and retain demonstrable consent evidence in the record.
How should signed forms be stored?
Store signed orders and results in secure, access-controlled systems with encryption at rest and in transit. Maintain audit trails showing signer attribution, timestamps, and any amendments to meet HIPAA and organizational retention policies.
Who is authorized to sign the order?
Typically an authorized ordering clinician (physician, nurse practitioner, or physician assistant) signs and attests to medical necessity. Delegated staff may complete the form but a licensed provider's signature or electronic attestation is required for most orders.

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