PATIENT INSTRUCTIONS FOR COLONOSCOPY
ON [date] YOUR DOCTOR HAS SCHEDULED YOU TO HAVE A COLONOSCOPY PROCEDURE
If you need to change or cancel your appointment, please call (718) 579-5300 Monday through Friday, 8:30 a.m. to 5 p.m. (except holidays).
YOU MUST DO THE FOLLOWING AT HOME STARTING 4 DAYS BEFORE THE PROCEDURE
- If you take oral diabetes medication do not take them on ________ [day before the procedure] and in the morning of the procedure.
- If you use insulin, take ½ the dose of _____________________ [name of basal insulin] on ________________ [day before the procedure] ONLY. DO NOT TAKE ANY INSULIN ON THE MORNING OF THE PROCEDURE.
- If you take blood pressure, heart, thyroid or seizure medication, take them the morning of the procedure with a sip of water.
- If you use asthma inhalers, use them before coming to the hospital
- Please continue taking your aspirin and anticoagulants as prescribed by your doctor.
Patient Signature Date
Nurse Signature Date