Colonoscopy Screening Questionnaire

Depending on your current condition, you may need to see a gastroenterologist before your colonoscopy. To determine if you need to be seen, please take a moment to answer the following questions. Your answers will be sent to a medical assistant at the clinic who will contact you to schedule the colonoscopy or an appointment with one of our gastroenterologists.

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Please use the date format MM/DD/YYYY (e.g. 11/28/1988)
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