Online Ordering Portal Signup

By signing up, physicians and delegates can have access to the benefits of Exact Sciences' online ordering portal.

Your Information

First Name*

Last Name*

Email Address*

NOTE: User will need access to this email address to activate their account.

Email Address*

Your Occupation*

NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

NPI Number*

Practice Information

Practice Name*

Practice Type*

Practice Address 1*

Practice Address 2

Practice City*

Practice State*

Practice Postal Code*

Practice Phone Number*

Practice Fax Number*

Are you an ordering provider or a delegate?

A delegate is a designee who is granted ordering privileges and can order on a provider’s behalf (i.e., nurse, medical assistant, lab tech).

Add Delegates to the Account

Delegates can fill out and submit online orders on the provider's behalf. If you do not need to add delegates to your account, you can skip this page.

NOTE: If you need to submit more than 5 new users, please contact Customer Service.

Practice Name*

Delegate Information:

Delegate #1

Delegate 1 First Name

Delegate 1 Last Name

Delegate 1 Email Address

NOTE: User will need access to this email address to activate their account.

Delegate 1 Email Address

Delegate 1 Occupation

Delegate #2

Delegate 2 First Name*

Delegate 2 Last Name*

Delegate 2 Email Address*

NOTE: User will need access to this email address to activate their account.

Delegate 2 Email Address*

Delegate 2 Occupation*

Delegate #3

Delegate 3 First Name*

Delegate 3 Last Name*

Delegate 3 Email Address*

NOTE: User will need access to this email address to activate their account.

Delegate 3 Email Address*

Delegate 3 Occupation*

Delegate #4

Delegate 4 First Name*

Delegate4 Last Name*

Delegate 4 Email Address*

NOTE: User will need access to this email address to activate their account.

Delegate 4 Email Address*

Delegate 4 Occupation*

Delegate #5

Delegate 5 First Name*

Delegate5 Last Name*

Delegate 5 Email Address*

NOTE: User will need access to this email address to activate their account.

Delegate 5 Email Address*

Delegate 5 Occupation*

Add Providers to the Account

NOTE: If you need to submit more than 5 new users, please contact Customer Service.

Practice Name*

Provider Information:

Provider

Please specify which provider(s) in the account you would like to be a delegate for. You must submit at least one provider.

Provider First Name*

Provider Last Name*

Provider Email Address*

NOTE: User will need access to this email address to activate their account.

Provider Email Address*

Provider Occupation*

Provider NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

Provider NPI Number*

Provider #2

Provider 2 First Name*

Provider 2 Last Name*

Provider Email 2 Address*

NOTE: User will need access to this email address to activate their account.

Provider Email 2 Address*

Provider 2 Occupation*

Provider 2 NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

Provider 2 NPI Number*

Provider #3

Provider 3 First Name*

Provider 3 Last Name*

Provider Email 3 Address*

NOTE: User will need access to this email address to activate their account.

Provider Email 3 Address*

Provider3 Occupation*

Provider 3 NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

Provider 3 NPI Number*

Provider #4

Provider 4 First Name*

Provider 4 Last Name*

Provider Email 4 Address*

NOTE: User will need access to this email address to activate their account.

Provider Email 4 Address*

Provider 4 Occupation*

Provider 4 NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

Provider 4 NPI Number*

Provider #5

Provider 5 First Name*

Provider 5 Last Name*

Provider Email 5 Address*

NOTE: User will need access to this email address to activate their account.

Provider Email 5 Address*

Provider 5 Occupation*

Provider 5 NPI Number*

The National Provider Identifier (NPI) is a unique identifier for covered healthcare providers. Look up your NPI

Provider 5 NPI Number*

Do you need to add additional delegates?

If you are adding additional delegates, they will also be granted ordering permissions for the listed provider(s).

Treatment Determination

Therapy Selection

Testing And Treating

Understanding Your Diagnosis

Online Ordering Portal Signup

Quick Links

Online Ordering Portal Signup

Your Information

Email Address*

NPI Number*

Practice Information

Are you an ordering provider or a delegate?

Add Delegates to the Account

Delegate #1

Delegate 1 Email Address

Delegate #2

Delegate 2 Email Address*

Delegate #3

Delegate 3 Email Address*

Delegate #4

Delegate 4 Email Address*

Delegate #5

Delegate 5 Email Address*

Add Providers to the Account

Provider

Provider Email Address*

Provider NPI Number*

Provider #2

Provider Email 2 Address*

Provider 2 NPI Number*

Provider #3

Provider Email 3 Address*

Provider 3 NPI Number*

Provider #4

Provider Email 4 Address*

Provider 4 NPI Number*

Provider #5

Provider Email 5 Address*

Provider 5 NPI Number*

Do you need to add additional delegates?

Confirm Your Information

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