Portal Registration

To initiate the OncoHost portal registration process, kindly complete the form below. Please note that approval of registration may take up to one business day.

If you are a medical professional registering on behalf of a physician, please do not use this form. Instead, reach out to contact@oncohost.com with your name, medical facility details, and the name(s) of the physician(s) you are registering. We will promptly register you to our portal within one business day.

For immediate test orders, please download our Test Requisition Form (TRF) and fax it to 1-919-415-1308.

Download TRF

Please fill your first name
Please fill your last name
Please fill your NPI
Please fill your fax
Please enter valid email address
Please fill your phone number
Please choose your specialty
Provide 'Other' details
Please fill your medical facility name
Please fill your city
Please fill your address
Please choose your state
Please fill your zip code
Submit

Your message has been sent

A relevant contact will be in touch soon

Send again
Oops! Something went wrong while submitting the form.