For Medical Oncologists:

  1. Complete the pathology preorder form below to request the patient’s sample from the pathology lab to be sent to Monogram for testing. 
  2. Fax the pathology preorder form to the pathologist’s office.
  3. Fax the pathology preorder form to Monogram’s Gateway line at 888-369-0023.
  4. The pathology lab will prepare the sample and ship it to Monogram. Monogram will follow up with the lab to ensure that we receive your sample.

For Pathologists:

  1. Request HERmark® assay kits from Monogram by calling our Client Services at 800-777-0177.
  2. Complete the test request form in the kit. See a sample test request form below.
  3. Prepare the sample for shipment. See Specimen Requirements and Shipping Instructions below.
  4. Submit the sample via FedEx®

FedEx is a registered trademark of Federal Express Corporation.