Self-Referral Colonoscopy

Self Referral Colonoscopy

Self-referral, or open access, colorectal cancer screening is for patients age 45-70 who are in generally good health, have no gastrointestinal symptoms, and require a routine colonoscopy (either initial or follow-up colonoscopy after initial screening) for colorectal cancer.

Eligible patients should meet the following criteria:

  • Age 45-70, 45 if African American, 40-49 for patients who have a first-degree relative with colon cancer age 50 or younger
  • No previous problems with moderate sedation or anesthesia
  • No anticoagulant or antiplatelet drugs (Coumadin, Plavix, etc.)
  • No significant illnesses including poorly controlled diabetes, significant cardiac disease, severe breathing problems, liver problems or kidney problems
  • No chronic use of narcotics, benzodiazepines or other sedatives
  • No gastrointestinal symptoms, e.g. abdominal pain, rectal bleeding, or change in bowel habits

Patients who meet the above criteria can register using one of three methods:

1. Complete theĀ  online self-referral colonoscopy questionnaire. We will review the submitted information and respond to you within 5 to 7 business days.

2. Download and complete the printable self-referral colonoscopy questionnaire. Once the questionnaire is completed, print and mail to:
Antwerp Regional Medical Center
c/o Dr. Matthew Hogan’s Office
608 S. Erie St., Antwerp, OH 45813

3. Call the PCH Antwerp Regional Health Center at 419-258-5641 to provide the required information.

Information submitted by the self-referral colonoscopy questionnaire or by telephone will be reviewed.

Please allow up to 5-7 business days before you receive a return telephone call to schedule the procedure and receive pre-procedure colonoscopy and preparation instructions.

If after review of the submitted information, our staff finds that the patient is not eligible for self-referral Colonoscopy, we will contact the patient to schedule a clinic appointment.