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COLORECTAL SCREENING COLONOSCOPY REFERRAL FORM FAX TO: 6133548230Instructions for Completion: This referral form is ONLY to be used to refer a patient for colonoscopy with: 1. A confirmed abnormal

How to fill out assessment of a colonoscopy

How to fill out assessment of a colonoscopy

1. Before the assessment, inform the healthcare provider about any medical conditions, allergies, or medications you are taking.
2. You may be asked to follow a clear liquid diet for a day before the assessment. Follow the instructions provided by the healthcare provider.
3. Take any prescribed laxatives or medications as instructed to clean out your colon. This is known as bowel preparation.
4. Arrive at the healthcare facility on the scheduled assessment day and complete the necessary paperwork.
5. Change into a hospital gown and lie on your side on the assessment table.
6. The healthcare provider will administer anesthesia to make you comfortable during the assessment.
7. A thin, flexible tube called a colonoscope will be inserted through the anus and guided into the colon.
8. The healthcare provider will carefully examine the lining of the colon using a camera attached to the colonoscope.
9. If any abnormalities or polyps are found, the healthcare provider may take tissue samples or remove the polyps for further examination.
10. After the assessment, you may experience mild bloating, cramping, or gas. This is normal and will improve over time.
11. Follow any post-assessment instructions provided by the healthcare provider, such as dietary restrictions or medications.
12. Report any severe abdominal pain, bleeding, or other complications to your healthcare provider immediately.

Who needs assessment of a colonoscopy?

1. People who are at an increased risk of colorectal cancer, such as those with a family history of the disease.
2. Individuals with certain digestive symptoms, such as unexplained abdominal pain, changes in bowel habits, or rectal bleeding.
3. People over the age of 45-50, as recommended by their healthcare provider.
4. Individuals with a history of polyps or previous colon cancer.
5. Those with a personal history of inflammatory bowel disease, such as Crohn's disease or ulcerative colitis.
6. People with certain genetic conditions or syndromes that increase the risk of colon cancer.
7. Individuals with a known or suspected gastrointestinal abnormality.
8. Those who are experiencing unexplained weight loss or iron deficiency anemia.
9. People who require routine screening for early detection of colorectal cancer.

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What is assessment of a colonoscopy?

An assessment of a colonoscopy is a formal evaluation of the procedure used to examine the interior of the colon and rectum for abnormalities, polyps, or signs of colorectal cancer. It includes analysis of the findings and the results of the procedure.

Who is required to file assessment of a colonoscopy?

Medical professionals and facilities that perform colonoscopies are typically required to file an assessment. This can include hospitals, outpatient surgery centers, and gastroenterology practices.

How to fill out assessment of a colonoscopy?

To fill out an assessment of a colonoscopy, healthcare providers need to complete a standardized form that includes patient information, details of the procedure, findings during the examination, any biopsies taken, and recommendations for follow-up care.

What is the purpose of assessment of a colonoscopy?

The purpose of an assessment of a colonoscopy is to ensure a thorough review of the procedure's findings, to document any abnormalities, and to inform patient management and follow-up care.

What information must be reported on assessment of a colonoscopy?

The assessment must report patient demographics, procedure date, indication for the colonoscopy, findings, any interventions performed, biopsy results if applicable, and follow-up recommendations.