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Ali
2023-11-30T00:13:52+00:00
1
Insurance
2
Your Info
3
Shipping
4
Payment
Please select one of the following
*
I am self-pay
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ColonCancerScreeningKit.com is in network with Blue Cross Blue Shield. We will verify eligibility and ship your kit.
Member Name
*
Member ID
*
Group Number
*
Please enter your Groupon voucher to redeem.
Groupon Voucher #
Coupon Code
FIT Kit
Price:
$40.00
Total
$0.00
PATIENT INFORMATION
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*
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Last
Date of birth
*
Date Format: MM slash DD slash YYYY
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and
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.
SHIPPING ADDRESS
Shipping Address
*
Kits are mailed via United States Postal Service. Only enter an address deliverable by USPS.
Street Address
Address Line 2
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PAYMENT INFORMATION
Total
$0.00
Billing Address
Same as shipping
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Credit Card
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Order Summary
Colon Cancer Test Kit
Qty: 1
$40.00
Discounts
Subtotal
Shipping
Free
Total