Date
A revised Esophagogastroduodenoscopy (EGD) and Colonoscopy Form with improved legibility is now available. This form is to be completed by primary care providers and internal medicine specialists when referring a patient to an endoscopist for an EGD or colonoscopy.
Endoscopists alerted the NH colonoscopist and primary care provider working groups that the shaded sections in the original form were difficult to read when received via fax. The working groups reviewed this concern and opted to remove the shading immediately. In place of the shading, the print has been bolded to indicate required sections.
For instructions on how to order and access the referral form from Document Source, please refer to the memo.