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Colonoscopy report template

Colonoscopy report sample 2026

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The document is a Colonoscopy Reporting Form used in the Colon Screening Program. It includes sections for patient information, procedure details, bowel preparation assessment, unplanned events, specimens taken, and comments for the pathologist. The form requires completion of specific fields related to the colonoscopy procedure and ensures proper documentation for quality assurance and follow-up care. It emphasizes confidentiality and provides instructions for sending pathology reports.

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Click ‘Get Form’ to open the colonoscopy report sample in the editor.
Begin by entering the patient’s name in the designated field, ensuring it is legible for multiple copies.
Fill in the date of birth, procedure date, and start time using the specified formats (dd/mmm/yyyy and 24 hr).
Select the hospital site and enter the name of the colonoscopist responsible for the procedure.
Complete any grey sections as required, including details about bowel preparation and cecal intubation.
Document any unplanned events that occurred during the procedure, selecting from options like perforation or bleeding.
In the specimens section, indicate whether any specimens were taken and provide comments for the pathologist if necessary.
Finally, ensure all signatures are completed before saving or sending your document directly from our platform.

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Versions	Form popularity	Fillable & printable
2015	4.8 Satisfied (140 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does colonoscopy cause gas?

Is Gas Normal After a Colonoscopy? Yes, gas and mild bloating are normal side effects. In most cases, the symptoms improve within a few hours after the trapped air passes.

What is a normal colonoscopy report?

Normal results This means no growths (polyps) or cancer have been found in your . If youre at higher risk of problems, you might be asked to have regular colonoscopies every few years to check everything is still okay.

What is the most common result of a colonoscopy?

10 Common Conditions Detected Through A Colonoscopy Ulcerative Colitis. Ulcerative colitis is a chronic inflammatory disease that affects the lining of the colon and rectum. Crohns Disease. Colon Polyps. Diverticulitis. Irritable Syndrome. Haemorrhoids. Constipation. Colorectal Cancer.

When to worry about colonoscopy results?

Following Up After a Colonoscopy But even with a negative exam, if you have a family history or develop any unusual symptoms, you may need earlier testing. Symptoms that need attention include: Blood in your stool. A change in your habits, like ongoing constipation or diarrhea.

What are abnormal findings on a colonoscopy?

A negative exam report means that the inside of your colon looks normal, with no polyps, abnormal tissue, or signs of cancer. Future screenings are still important, though, because things can change as you age.

sample colonoscopy report

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How do you read the results of a colonoscopy?

Positive result A colonoscopy is considered positive if the doctor finds any polyps or abnormal tissue in the colon. Most polyps arent cancerous, but some can be precancerous. Polyps removed during colonoscopy are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous.