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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.



Return Patient Forms

The form below can be used to securely upload your patient forms to our servers.
The secure form is HIPPA and PCI DSS compliant and is the only electronic method that can be used to return your forms. Do not email your forms.

Before submitting your forms, please ensure:

1) You have completed the entire form and saved the file to your computer.
2) All signature fields are either electronically or hand signed.
3) All forms need to be in one file. Separate files for each page will not be accepted.

You can learn more about regulatory compliance of this transfer method here.


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