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Colon Cancer Check Program Referral Form
To submit referral fax to Pembroke Regional Hospital, OR Fax: 6137326345
Indication for referral:
This screening is applicable for patients 50 to 74 years
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How to fill out colon cancer check program

How to fill out colon cancer check program
01
Step 1: Contact your healthcare provider and ask about the colon cancer check program.
02
Step 2: Schedule an appointment with your healthcare provider to discuss the program and any necessary preparations.
03
Step 3: Follow any instructions provided by your healthcare provider regarding dietary restrictions or medication adjustments before the check program.
04
Step 4: Arrive at the healthcare facility on the scheduled date and time for the check program.
05
Step 5: Follow the check program procedure as directed by the healthcare professionals, which may involve taking samples or undergoing imaging tests.
06
Step 6: Cooperate with healthcare professionals during the check program and provide any necessary information or samples.
07
Step 7: Wait for the check program results to be analyzed and interpreted by healthcare professionals.
08
Step 8: Discuss the results with your healthcare provider to understand the implications and potential follow-up actions.
09
Step 9: Follow any recommended follow-up actions or treatments as advised by your healthcare provider.
Who needs colon cancer check program?
01
Individuals who are at an increased risk of developing colon cancer.
02
Individuals with a family history of colon cancer.
03
Individuals above a certain age (usually 45 or 50) as recommended by healthcare guidelines.
04
Individuals with certain inherited genetic conditions that predispose them to colon cancer.
05
Individuals with a personal history of colorectal polyps or inflammatory bowel disease.
06
Individuals with symptoms that may indicate colon cancer, such as persistent changes in bowel habits, abdominal pain, blood in the stool, or unexplained weight loss.
07
It is always best to consult with your healthcare provider to determine if you are a candidate for the colon cancer check program.
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What is colon cancer check program?
The colon cancer check program is a screening program designed to detect signs of colon cancer early on.
Who is required to file colon cancer check program?
Individuals over a certain age or with certain risk factors may be required to participate in the colon cancer check program.
How to fill out colon cancer check program?
The colon cancer check program typically involves a screening test, which can be done at a doctor's office or through a take-home kit.
What is the purpose of colon cancer check program?
The purpose of the colon cancer check program is to catch colon cancer in its early stages when it is most treatable.
What information must be reported on colon cancer check program?
The colon cancer check program may require reporting personal and medical information, as well as test results.
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