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JOSEPH'S SCREENING COLONOSCOPY REFERRAL FORM 2026
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- Click ‘Get Form’ to open JOSEPH'S SCREENING COLONOSCOPY REFERRAL FORM in our editor.
- Begin by filling out the 'Patient Information' section. Enter the patient's name, health insurance number (HIN), date of birth, street address, city/town, postal code, home phone number, and work phone number.
- In the 'Indication for Procedure' section, check all applicable boxes that apply to the patient's condition, such as positive FOBT or a first-degree relative with colorectal cancer.
- Complete the 'Referring Physician Information and Instructions' section by entering the physician's name, referring physician number, office phone, and fax number.
- Fill out the 'Clinical Information' section. Indicate any allergies and conditions that may affect the procedure by checking relevant boxes. Include medications with doses and frequency if applicable.
- Finally, ensure you review both risks and benefits of colonoscopy with the patient. If you do not wish for direct referral for follow-up of positive findings, check that option before signing and dating the form.
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Is the colonoscopy prep painful?
Theres no getting around it; colonoscopy prep may become more unpleasant as the hours go by. The skin around your anus could become so irritated that wiping will be painful. It can help to use baby wipes, but be sure to use the unscented kind, or youll risk irritation from the perfumes in scented wipes.
What happens at a pre assessment for colonoscopy?
Pre assessment appointment Patients attending for a Colonoscopy procedure are seen by a pre assessment nurse prior to the date of their procedure. At this appointment the pre assessment nurse takes information from you and advises you how to prepare for the procedure.
What is a colonoscopy pre screening?
A screening colonoscopy is a preventive procedure to examine the colon to ensure its healthy. All adults 45 and older need screening because colon cancer is one of the most common and deadly cancers. It is also typically treatable when its caught early.
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People also ask
What does a colonoscopy screening consist of?
For this test, the doctor looks at the entire length of the colon and rectum with a colonoscope, a flexible tube about the width of a finger with a light and small video camera on the end. Its put in through the anus and into the rectum and colon.
Is colonoscopy therapeutic?
A therapeutic colonoscopy is one where your physician takes action during the procedure to correct a disorder, such as removing a polyp, stopping bleeding, or dilating (stretching) a narrowed area called a stricture.
What to expect during colonoscopy prep?
Colonoscopy preparation typically involves taking a laxative to clear your bowels and electrolytes to prevent dehydration. Some people may need to perform an at-home enema, injecting a liquid and stool softener through the rectum, to stimulate bowel movements.
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