Schedule Now
Facility Locations

What is the ColonoscopyAssist Program About?

  • The ColonoscopyAssist program promotes colon cancer screening among the uninsured community
  • The following tests are provided at heavily discounted rates:
    1. Colonoscopy
    2. Upper Endoscopy
    3. Cologuard
    4. FIT
  • Financial assistance is provided to patients unable to afford the tests.
  • The program focuses on removing financial barriers to CRC screening.

 

 

Request an Appointment

  

To request an appointment, please fill out the form below

  • » If you would like to find the facility closest to your zip code, please visit the facility locator page.
  • » Upon submission of this form, you will be asked to select your provider and complete your scheduling forms. Completion of the scheduling forms will result in a scheduled appointment.
  • » If you intend to utilize our payment plan options, you can apply for a payment plan here.
  • » You can read our Privacy Policy here.

* Indicates a required field

 
Patient Information
* Gender
* Do you have a physician referral?
Contact Information
 
(We will attempt to reach you twice. Please ensure that you are available to answer our call)
Appointment Information

 

The use or transmittal of this form does not create a physician-patient relationship. More information regarding the confidentiality of this request can be found in our Privacy Policy.

 
  (Form may take up to 30 seconds to submit)