The Open Access Colonoscopy Program has been developed to meet an increasing demand for colonoscopy performed exclusively for screening for colorectal cancer. In the year 2017, estimated 135,000 new cases of colorectal cancer were diagnosed in the United States, and approximately 50,000 people died from this disease.
Generally healthy patients who either decided to be screened on their own or who were advised to be screened by their doctors qualify for the program and can have procedure completed without the requirement to be seen in a doctor office visit before the actual colonosopic examination.
We have developed a web-based form that will automatically ask you all necessary questions to see if you qualify for the program and allows you to make the process as easy as possible.
Once you have completed and submitted form, we will receive the questionnaire, and you will be contacted by one of our employees within 10-14 business days. Our staff will complete the pre-screening process and can answer any questions for you at that time.
Appointment times can vary and can be booked within a few days to a few weeks from the time of the request, depending on the volume, so please send in the information as soon as possible so we can accommodate your schedule!
STEP 2 Please, carefully read the included brochure entitled “Colonoscopy”. It will provide you with information about the colonoscopic technique, its applications, and possible risks and complications.
STEP 3 Your colonoscopy will be performed by Dr. Andrzej Janecki, who is an experienced gastroenterologist who has successfully performed over 20,000 colonoscopies.
STEP 4 Please complete the online pre-colonoscopy patient questionnaire form below. After completion, please carefully read and sign the patient statement which follows the questionnaire. In the last step, you may indicate your preference as to the date and location of the procedure.
NOTE: Once you complete the online form via your computer or mobile device; it is sent to us directly (by clicking on SUBMIT button at the end of questionnaire).
NOTE: If you have certain health conditions and/or take certain medication you may not qualify for Open Access Colonoscopy Program. You may still qualify for screening colonoscopy, but you should schedule an appointment with Dr. Janecki prior to the procedure to discuss the best screening options for you.
Below please find a list some of the conditions and/or medications which would require an office visit prior to scheduling a screening colonoscopy procedure.
1. Recent heart attack or recent heart surgery (within last 3 months).
2. Implanted or external cardiac defibrillator (a simple pacemaker is acceptable)
3. Recent cardiac ablation procedure for irregular heart beat (within last 3 months)
4. Recent hospitalization at the level of Intensive Care Unit for any reason (within the last month)
5. Recent stroke (within the last 3 months)
6. Partial removal of the intestine with colostomy or ileostomy bag currently in place.
7. Personal history of heart, liver or kidney transplant.
8. If you are currently taking anticoagulants (“blood thinners”) including but not limited to, Coumadin (Warfarin), Clopidogrel (Plavix), Xarelto (Rivaroxaban), Pradaxa (Dabigatran), or Eliquis (Apixaban), PLEASE NOTE: Some conditions requiring blood thinners may not disqualify you from Open Access Colonoscopy program. Please call us at 281-394-0266 and talk to Katherine for advice.
If you have ANY of the above conditions or treatments please call us to schedule a pre-colonoscopy office visit at (281) 394-0266.
Online Pre-colonoscopy Patient Questionnaire Form
If you need to physically fill out the form offline in an PDF format, you can email, fax or US Postage (snail mail) it back to us. These options are still available to you if you cannot complete form online.