Procedure Prep Forms

General Procedure Prep Instructions

• If you are pregnant, please discuss the risks and benefits of this procedure with your physician.
• If you take anti-coagulants / blood thinners (for example: Coumadin, Plavix, Pradaxa, Xarelto, Eliquis, Effient, Brilinta, etc.) or Insulin, please notify our office at least 10 days prior to your procedure.
• Please inform us if you weigh greater than 250 lbs., have kidney disease, congestive heart failure, artificial heart valves, a pacemaker or defibrillator (AICD), sleep apnea, or ascites.
• Please discontinue iron or fiber supplements, seeds, nuts, popcorn, and raw vegetables one week before your colonoscopy.
• Colonoscopies require a “Clear Liquid” diet as part of the preparation. Approved Clear Liquids:
  • Water, Black Coffee or Black Tea (no cream or artificial cream)
  • Strained fruit juices WITHOUT pulp (Example: apple, white grape)
  • Clear Broth or Bouillon (Example: chicken or beef or vegetable broth)
  • Carbonated CLEAR soft drinks (Example: Sprite, ginger ale)
  • Gatorade, Kool aid or lemonade with no pulp (NO RED OR PURPLE)
  • Plain Jell-O (without fruit or toppings) (NO RED OR PURPLE)
  • Popsicles (NO RED OR PURPLE)
  • NO DAIRY PRODUCTS
  • NO ALCOHOLIC BEVERAGES
• FOR ANY PROCEDURE WITH ANESTHESIA
  • Do NOT use any tobacco products or marijuana, do NOT take non-prescribed drugs, and do NOT drink alcohol after midnight before your procedure.
• Driving after your procedure:
  • Please make arrangements to have someone drive you to and from the designated location for your procedure.
  • You will not be allowed to use any form of public transportation following your procedure, which includes: Taxi, Bus, Ride-share service, Uber, Lyft and the like.
  • The test may be canceled if you do not have a driver, there will be no exceptions.
  • You will be under sedation during your procedure and will be unable to work, drive or operate heavy machinery the day of your procedure.